2026/04/17 by Clémence Ramier, Virginia Hernandez-Gea, Laure Elkrief +11 · 1 voice
Medicine · #Cardiac Health and Mental Health #Liver Disease Diagnosis and Treatment #Liver Disease and Transplantation
paper · pdf · doi:10.1016/j.jhepr.2026.101861
openalex publication_date 2026/04/17 · openalex created_date 2026/04/18 · openalex updated_date 2026/08/01
BACKGROUND & AIMS: Patient-reported outcomes (PROs) are scarce in vascular liver diseases (VLD), including portal vein thrombosis (PVT) and Budd-Chiari syndrome (BCS). This study aimed to assess health-related quality of life (HRQoL), fatigue, and depressive symptoms in patients with VLD and to identify associated factors. METHODS: We performed a multicentre cross-sectional study in France, Spain, and Switzerland. Patients with PVT or BCS were asked to fill out validated questionnaires assessing health-related quality of life (HRQoL; EQ-5D-5L), fatigue (Modified Fatigue Impact Scale - short form; MFIS-5), and depressive symptoms (Patient Health Questionnaire-8; PHQ-8). Clinical and sociodemographic data were collected. Linear and logistic regression analyses were used to identify factors associated with the three PROs. Comparisons with the general population were conducted. RESULTS: Among 1,136 eligible patients, 488 respondents completed the three PROs. The mean ± SD HRQoL score was 0.885 ± 0.146, significantly lower than that of the French general population but comparable to the Spanish general population. Depressive symptoms were reported in 24.8% of patients (vs. 9.8% and 3.7% in the French and Spanish general populations, respectively). After indirect standardisation for gender, age, and education, the prevalence of depressive symptoms was three times higher in French patients than in the French general population. Lower HRQoL and greater fatigue were significantly associated with female gender, financial difficulties, self-reported comorbidities, and a history of hepatic encephalopathy on multivariable analysis. Depressive symptoms were associated with female gender, financial difficulties, and antiphospholipid syndrome, whereas anticoagulation therapy was associated with better outcomes. CONCLUSIONS: The disease burden in patients with VLD is significant, with impaired HRQoL and high rates of fatigue and depressive symptoms. Hepatic encephalopathy, gender, and socioeconomic factors are key drivers, emphasising the need for comprehensive care approaches that integrate psychological and social support with clinical management. IMPACT AND IMPLICATIONS: This study provides new insight into the disease burden of VLDs by quantifying the prevalence of impaired HRQoL, fatigue, and depressive symptoms in patients with PVT and BCS. Our findings show that female gender and socioeconomic factors, especially financial difficulties, have a more important role compared with clinical severity in predicting PRO measures. These results show the association between anticoagulation therapy and lower levels of fatigue and depression, and the need to expand current care models beyond medical treatment to include psychological support and patient education programs to manage fatigue. Future longitudinal studies are needed to monitor the long-term evolution of these outcomes.