Clinical data regarding quality of life in patients with refractory ascites is limited and preceded the development of newer questionnaires that may be more robust. One primary objective of this study is to study changes in quality in life in a prospective fashion using newer general and ascites-specific quality of life survey instruments specific to benign and malignant etiologies. Sarcopenia is a condition that is prevalent in cancer and cirrhosis. Current data is retrospective and associative, evaluating heterogeneous patient populations at different stages within the timeline of refractory ascites. The other primary objective of this study is to study sarcopenia in a prospective fashion and to understand its kinetics once a patient develops refractory ascites. Prospectively-obtained measures of deterioration in patient-reported outcomes and in muscle mass will form the basis for the next stage of investigation of interventions to mitigate these declines.
Patients with refractory ascites defined as requiring \>1 paracentesis within a 6 week period will be prospectively enrolled. The Patient-Reported Outcomes Measurement Information System (PROMIS-10) and ascites-specific (Ascites Q and Edmonton Symptom Assessment System: Ascites Modification) quality of life questionnaires will be obtained at baseline, then at 1-, 2-, 4- and 6 months. Sarcopenia will be assessed by muscle area measurement from a single CT image at the L4 level at baseline, 2- and 6 months.
Study Type
OBSERVATIONAL
Enrollment
70
QoL and sarcopenia assessments
University of Pennsylvania Perelman School of Medicine
Philadelphia, Pennsylvania, United States
RECRUITINGHealth-Related Quality of Life scores as measured by the PROMIS-10 questionnaire
Patient-Reported Outcomes Measurement Information System (PROMIS-10) survey scores physical and mental health on a 4-20 point scale which are combined into an overall score with higher scores reflecting better quality of life.
Time frame: 6 months
Sarcopenia as measured by psoas, paraspinal, and total abdominal wall muscle areas
assessed by a limited CT scan of the abdomen at the level of L4. Cross-sectional muscle area is measured.
Time frame: 6 months
Ascites-specific QOL scores as measured by the Ascites Q for patients with cirrhotic ascites.
Ascites Q asks 11 questions on a 2-11 scale. Total is normalized to a 0-100 point scale with higher score reflecting worse symptoms.
Time frame: 6 months
Ascites-specific QOL scores as measured by the Edmonton Symptom Assessment System: Ascites Modification for patients with malignant ascites,
11 questions on a 0-10 scale, total score range 0-110 with higher score reflecting worse symptoms.
Time frame: 6 months
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