Development and predictive validity of the cirrhosis-associated ascites symptom scale: A cohort study of 103 patients

Research output: Contribution to journalJournal articlepeer-review


  • WJG-24-424

    Final published version, 1.59 MB, PDF document

  • Agnete Nordheim Riedel
  • Nina Kimer
  • Anne-Sofie Houlberg Jensen
  • Emilie Kristine Dahl
  • Mads Israelsen
  • Luise Aamann
  • Gluud, Lise Lotte

AIM: To develop a scale of domains associated with the health-related quality-of-life (HRQOL) in patients with cirrhosis-related ascites.

METHODS: We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom (CAS) scale describing symptoms with a potential detrimental impact on health related quality of life (HRQL) (the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with (1) tense/severe; (2) moderate/mild; or (3) no ascites (controls). Patients also completed chronic liver disease questionnaire (CLDQ) and the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations.

RESULTS: The final CAS scale included 14 items. The equivalent reliability was high (Chronbach's alpha 0.88). The validation cohort included 103 patients (72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls (mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites (mean = 23.8 points) as well as moderate/mild ascites (mean = 18.6 points) (P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score (rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score (0.67, P < 0.001).

CONCLUSION: The CAS is a valid tool, which reflects HRQOL in patients with ascites.

Original languageEnglish
JournalWorld Journal of Gastroenterology
Issue number15
Pages (from-to)1650-1657
Publication statusPublished - 2018

    Research areas

  • Aged, Ascites/diagnosis, Cohort Studies, Cross-Sectional Studies, Denmark, Female, Humans, Liver Cirrhosis/complications, Male, Middle Aged, Quality of Life, Reproducibility of Results, Surveys and Questionnaires

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