Understanding the patient perspective of weight management while on the liver transplant waitlist

Ariana Chirban , Anushi Shah , Taylor M Coe , Heidi Yeh , Jennie Galpern , Jessica Witchey , Lorraine Castaldo , Nahel Elias , Angela Fitch , Leigh Anne Dageforde
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Abstract

Introduction

Obesity-associated comorbidities increase risks for patients undergoing liver transplant. In this study, we explore patient perspectives and motivation for healthy weight management among patients on the liver transplant waiting list.

Methods

This is a cross-sectional, observational, electronic survey-based study. A survey on weight management was administered to patients on the liver transplant waiting list. Demographic and clinical data were collected from patients’ medical records. Data was analyzed using Pearson's chi-squared, Fisher's exact, and Student's t-tests.

Results

Respondents had a mean age of 54.4 years, were predominately male (62.0%) with a mean BMI of 29.2 kg/m2 with alcoholic cirrhosis as the leading etiology of liver disease (33.9%). Among patients with a BMI≥30 kg/m2, 59.0% perceived that they were overweight and 23.1% believed they were underweight. Among patients with BMI≥30 kg/m2 who perceived they were overweight, 39.1% were actively trying to lose weight and 60.9% were trying to keep from gaining weight. Regardless of current weight, there was a median increase in BMI for patients who categorized themselves as having lost weight or maintained weight since being waitlisted.

Conclusion

Many patients with a BMI≥30 kg/m2 did not perceive themselves as overweight and were not actively trying to lose weight. Weight perception was not consistent with actual weight change while waitlisted for liver transplant. Further research is needed to understand how weight awareness and weight perception impacts motivation for weight loss.

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了解患者的体重管理的角度,而在肝移植等待名单
肥胖相关的合并症增加了接受肝移植患者的风险。在这项研究中,我们在肝移植等待名单上的患者中探讨了患者的观点和健康体重管理的动机。方法这是一项基于横断面、观察性、电子调查的研究。对肝移植等待名单上的患者进行了一项关于体重管理的调查。从患者的医疗记录中收集人口统计学和临床数据。使用皮尔逊卡方检验、Fisher精确检验和Student t检验对数据进行分析。结果被调查者平均年龄54.4岁,主要为男性(62.0%),平均BMI为29.2kg/m2,酒精性肝硬化是肝病的主要病因(33.9%)。在BMI≥30kg/m2的患者中,59.0%的人认为自己超重,23.1%的人认为体重不足。在BMI≥30 kg/m2且认为自己超重的患者中,39.1%的患者积极尝试减肥,60.9%的患者试图避免体重增加。无论目前的体重如何,那些自被列入候补名单以来将自己归类为减肥或保持体重的患者的BMI中位数都有所增加。结论许多BMI≥30kg/m2的患者并不认为自己超重,也没有积极尝试减肥。在等待肝移植时,体重感知与实际体重变化不一致。需要进一步的研究来了解体重意识和体重感知如何影响减肥动机。
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