A prospective observational study on tolerance and satisfaction to hepatic haemodynamic procedures

Liver Int. 2015 Mar;35(3):695-703. doi: 10.1111/liv.12522. Epub 2014 Mar 27.

Abstract

Background: Understanding patients' attitudes to clinical experiences is essential for developing high-quality patient-centred healthcare, as a better knowledge of patients' tolerance and satisfaction might allow implementing measures that ameliorate comfort, care and use of resources.

Aims: We aimed to describe patients' tolerance and satisfaction to invasive hepatic haemodynamic procedures, and to investigate which factors might influence patients' perspective in this field.

Methods: Visual Analogue Scale (VAS) questionnaires regarding pain and duration (for tolerance), and comfort and general handling (for satisfaction) were prospectively administered to all consecutive patients (N = 327) submitted to hepatic haemodynamic procedures (N = 355) in a tertiary care setting during 2011. VAS scores ranged between 0 and 100 mm and items were defined as excellent if <10 mm; good if 10-20 mm and inadequate if >20 mm. Clinical and laboratory data were also collected.

Results: Satisfaction was excellent in >95% of cases (mean 2 ± 5 mm, median 0 mm) and average tolerance was good (15 ± 18 mm; median 6 mm). A percentage of 59% of patients had excellent tolerance, 9% good and 32% had inadequate tolerance. Duration and complexity of the procedure and limited operator's experience were associated with inadequate tolerance on univariate analysis; duration of the procedure remained the only independent factor associated with inadequate tolerance on multivariate analysis. Procedures lasting <35 min had a >80% probability of being well tolerated.

Conclusions: Satisfaction and tolerance to hepatic haemodynamic procedures are excellent and good respectively. Tolerance was decreased in long procedures; hence reducing as much as possible the duration of the procedures might further improve tolerance.

Keywords: HVPG; liver biopsy; patient-centred healthcare.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Female
  • Hemodynamics
  • Humans
  • Liver Diseases / diagnosis*
  • Liver Diseases / therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pain Measurement
  • Pain Threshold*
  • Patient Satisfaction / statistics & numerical data*
  • Patient-Centered Care
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires