A Comparison of Different Frailty Scores and Impact of Frailty on Outcome in Patients With Cirrhosis.
J Clin Exp Hepatol
; 12(2): 398-408, 2022.
Article
en En
| MEDLINE
| ID: mdl-35535083
Background & aims: There is no "gold standard" tool for the assessment of frailty in cirrhosis. This study compares Liver Frailty Index (LFI), Short Physical Performance Battery (SPPB), Fried Frailty Criteria (FFC), and Clinical Frailty Scale (CFS) for frailty assessment and ascertains its impact on predicting mortality and hospitalizations in a cohort of outpatients with cirrhosis. Methods: 116 patients were enrolled in this prospective observational cohort study. Frailty assessment was done using LFI, SPPB, FFC, and CFS. All patients were followed up for 6 months. The primary outcome was the first of either all-cause unplanned hospitalization or all-cause mortality occurring within 6 months of the study period. Results: 100 (86.2%) males and 16 (13.8%) females with a mean age of 50.2 (48.4-51.9, 95% CI) years were included. The most common cause of cirrhosis was alcoholic liver disease (47.4%) followed by hepatitis C (12.9%) and Nonalcoholic steatohepatitis (NASH) (10.3%). There was no significant difference in prevalence of frailty based on LFI (43.1%), FFC (36.2%), CFS (44%), and SPPB (47.4%) (P > 0.05). Frail patients had worse outcomes compared to the Not frail group. At 6 months, the mortality rate in Frail patients was 42% versus 1.5% for the Not frail; hospitalization in Frail patients occurred in 92% versus 6% in the Not frail. On multivariable analysis, independent predictors of mortality were Frailty [OR 14 (1.4-54.2)], alcohol-related cirrhosis [OR 4.2 (1.1-16.3)], Child-Turcotte-Pugh (CTP) [OR 2.1 (1.4-2.9)] and Chronic liver disease questionnaire (CLDQ) [OR 0.1 (0.1-0.4)] scores. Conclusions: LFI, SPPB, FFC, and CFS are comparable in frailty assessment in patients with cirrhosis. Importantly, comparability of the commonly used scores for frailty assessment and prediction of hospitalization and mortality allows flexibility for clinical application.
AKI, Acute Kidney Injury; ANOVA, Analysis Of Variance; AUC, Area Under the Curve; CFS, Clinical Frailty Scale; CI, Confidence Interval; CLDQ, Chronic liver disease questionnaire; CT, Computerized Tomography; CTP, Child-Turcotte-Pugh; FFC, Fried Frailty Criteria; FSS, Fatigue severity scale; HCC, Hepatocellular Carcinoma; HE, Hepatic Encephalopathy; HU, Hounsfield Units; IBM, International Business Machines; LFI, Liver Frailty Index; MELD, Model for End-Stage Liver Disease; MELDNa, Model for End-Stage Liver Disease with Sodium; MMSE, Mini-Mental State Examination; NASH, Nonalcoholic Steatohepatitis; NPV, Negative Predictive Value; PGIMER, Post Graduate Institute of Medical Education and Research; PPV, Positive Predictive Value; ROC, Receiver Operating Characteristic Curve; SBP, Spontaneous Bacterial Peritonitis; SPPB, Short Physical Performance Battery; SPSS, Statistical Package for Social Sciences; UTI, Urinary Tract infection; cirrhosis; frailty; hospitalization; mortality
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Clin Exp Hepatol
Año:
2022
Tipo del documento:
Article
País de afiliación:
India
Pais de publicación:
India