Avaliação da fadiga nos pacientes candidatos a transplante de fígado em um hospital terciário

Abstract

Fatigue is a frequent complaint among patients with liver transplant liver disease causing limitations in the lives of these patients. Objectives: To evaluate the fatigue of patients who are candidates for liver Tx compared to a control group and to correlate with exercise capacity, clinical and laboratory data, disease severity, quality of life and anxiety and depression. METHODS: This is a cross-sectional study conducted in the tertiary hospital from July 2015 to July 2017. Patients candidates for TxH over the age of 18 years who were followed up by the hospital outpatient clinic and presented clinical conditions to perform the procedures proposed. It was included the control group, individuals recruited by means of the filling of a specific form formulated by the researcher, being able to be companion of the patient of the study or people of the same age group of age, who did not present comorbidities. Pre-operative evaluation variables: age, sex, previous lung disease, respiratory symptoms, severity of liver disease by the Model for End-stage Liver Disease (MELD) scale and the CHILD-PUGH classification, cause of transplantation, walking test of 6 minutes (6MWT), step test, fatigue questionnaire and quality of life evaluation, anxiety and depression. Results: 95 patients aged 45.9 ± 12.3 years, 53% of whom were women. The hepatopaths compared to the control group presented more fatigue by both FSS and VAS: 38 ± 14.3 vs 32.9 ± 8 with p = 0.003 and 5.6 ± 1.7 vs 3.2 ± 1.5 with p = 0.001 respectively. It was observed that patients presented a worse quality of life in relation to the control group in both the physical component and the summarized mental component of SF-36 (33.3 ± 2.2 vs 50.5 ± 2.3 with p = 0.001 and 26.6 ± 4.1 vs 54 ± 2.1 with p = 0.001 respectively). Finally, patients presented greater psychic distress than the control group with higher anxiety scores, (11.6 ± 1.8 vc, 6.4 ± 2.6 and p = 0.001). There was a direct correlation of the Borg dyspnea scale with FSS and VAS (r = 0.25, with p = 0.01 and r = 0.31, with p = 0.002 respectively). The variable with the best association with FSS was the step test (coefficient -0,19, 95% confidence interval (CI) = [-0.35 - (- 0.03)]. the coefficient -0.091, confidence interval 95% (CI) = [-0.17 - (- 0.044)] and the step test (coefficient -0,021, confidence interval 95% In the present study, patients with hepatic transplantation presented a high degree of fatigue and there was an inverse correlation of fatigue with the step and hematocrit test, and a direct correlation with degree of dyspnea. Keywords: fatigue. hepatic transplantation. exercise.