Estimation of Disability-Adjusted Life Years among Patients Presenting with End-Stage Liver Disease

Author(s): Aizaz Khalid, Umar Farooque, Tooba Laeeq, Anoosh Farooqui, Rizwan Farooque, SM Ismail Shah, Ali Mustafa, Syed Adeel Hassan, Mahwish Ahmed, Nabeel Hussain

Introduction: Disability-adjusted life years (DALYs) is a multidimensional metric utilized to quantify specific disease burdens. It has the potential to highlight both fatal and non-fatal outcomes of disease and thus help in policymaking and health resource allocation. Chronic liver disease, secondary to preventable causes, is one of the main contributors to morbidity and mortality. It demands the attention of researchers and policymakers alike. The primary aim of this study was to quantify the disease burden due to end-stage liver disease in terms of years of life lost (YLL), years lost to disability (YLD), and DALYs.

Materials and methods: This was a descriptive case-series study conducted over a period of six months between September 2019 and February 2020 at a tertiary care hospital in Lahore, Pakistan. All patients presenting with end-stage liver disease were interviewed. The YLL were predicted by using the Child-Pugh score’s estimation of years of life left. Chronic Liver Disease Questionnaire (CLDQ) was used to assess the disabilities of the patients along with disability weights from the Global Burden of Disease (GBD) study to calculate the YLD. All statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 23.0.

Results: 18 patients who presented with end-stage liver disease had 32.8 (95% CI: 25.2-40.5) mean DALYs. The mean age of presentation was 51.1 (95%CI: 42.7-59.4) years. A significant negative correlation was found between age and DALYs (r=-0.94, p<0.001). The mean YLL was 31.5 (95%CI: 23.5-39.5) and the mean YLD was 1.34 (95%CI: 0.58-2.11). Most patients presented with decompensated chronic liver disease (DCLD) during the fifth and sixth decade of life. No significant correlation was found between gender and DALYs (r = 0.208, p=0.407).The most common adjusted disabilities were muscle cramps, fatigue, difficulty sleeping at night, h

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