Inadequate social support decreases survival in decompensated liver cirrhosis patients

Introduction: Inadequate social support is associated with higher mortality both in the general population and in patients with chronic diseases. There are no studies that have described social support in liver cirrhosis and its impact on prognosis. Objectives: To analyze the impact social support has in the survival of patients with decom-pensated cirrhosis. Methods: Prospective multicentric cohort study (2016-2019). Patients with decompensated liver cirrhosis were included. Epidemiological, clinical and social variables were collected, using the validated Medical Outcomes Study Social Support Survey, with a 12-month follow-up. Results: A total of 127 patients were included, of which 79.5% were men. The most common etiology of cirrhosis was alcohol (74.8%), mean age was 60 years (SD 10.29), mean MELD was 15.6 (SD 6.3) and most of the patients had a Child -Pugh B (53.5%) or C (35.4%). In the assessment of social support, we observed that most of the patients (92.2%) had adequate global support. At the end of the follow-up (median 314 days), 70.1% of the patients survived. The 1-year survival rate in patients with inadequate global social support was 30%, compared to 73.5% in the presence of social support. In multivariate Cox regression analysis, inadequate social support predicted survival with an adjusted HR of 5.5 (95% CI 2,3-13,4) independently of MELD (HR 1.1, 95% CI 1-1.2), age (HR 1, 95% CI 1--1.1) and hepatocarcinoma (HR 10.6, 95% CI 4.1-27.4). Conclusion: Adequate social support improves survival in liver cirrhosis, independently of clin-ical variables. Social intervention strategies should be considered for their management. (c) 2022 Elsevier Espana, S.L.U. All rights reserved.

Automated summary

Inadequate social support is associated with higher mortality in the general population and in patients with chronic diseases. However, there is a lack of studies on social support in liver cirrhosis and its impact on prognosis. This study analyzed the impact of social support on the survival of patients with decompensated cirrhosis. The results showed that inadequate social support predicted lower survival rate, while adequate social support independently improved survival rate, regardless of clinical variables. Therefore, social intervention strategies should be considered in the management of liver cirrhosis.