Editorial: quality of life and mortality in cirrhosis and ascites

First paragraph: MacDonald et al1 report an important study showing that health‐related quality of life (HRQL) predicted mortality in 405 patients with cirrhosis and severe ascites. HRQL was assessed using the SF‐36 which has two main subscales assessing physical (PCS) and mental (MCS) components. They found (a) patients with severe ascites reported poor HRQL (particularly PCS), (b) PCS was not correlated with traditional markers of liver disease and (c) after controlling for confounders, PCS (but not MCS) was a significant predictor of all‐cause and cirrhosis‐related death. While the presence of diuretic‐refractory ascites is known to be a predictor of mortality, HRQL is not a component of the current model for end‐stage liver disease (MELD).