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Evaluation of Five Screening Tools in Detecting Physical Frailty in Cirrhosis and Their Prognostic Role.
Geladari, Eleni; Alexopoulos, Theodoros; Vasilieva, Larisa; Tenta, Roxane; Mani, Iliana; Sevastianos, Vassilios; Alexopoulou, Alexandra.
Afiliación
  • Geladari E; 3rd Department of Internal Medicine and Liver Outpatient Clinic, Evangelismos General Hospital, 10676 Athens, Greece.
  • Alexopoulos T; Gastroenterology Department, Medical School, Laiko General Hospital, National & Kapodistrian University of Athens, 11527 Athens, Greece.
  • Vasilieva L; Department of Gastroenterology, Alexandra General Hospital, 11528 Athens, Greece.
  • Tenta R; Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece.
  • Mani I; 2nd Department of Internal Medicine and Research Laboratory, Medical School, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
  • Sevastianos V; 3rd Department of Internal Medicine and Liver Outpatient Clinic, Evangelismos General Hospital, 10676 Athens, Greece.
  • Alexopoulou A; 2nd Department of Internal Medicine and Research Laboratory, Medical School, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
J Clin Med ; 13(17)2024 Aug 30.
Article en En | MEDLINE | ID: mdl-39274382
ABSTRACT

Background:

Physical frailty (PF) is a syndrome of decreased physical function and reserves, preventing patients from coping with stressful events. PF screening tools in patients with liver cirrhosis (LC) can help evaluate the risk of complications and death. The aim of this study was to assess the performance of five screening tools in detecting PF and their ability to predict 18-month mortality in LC.

Methods:

The Short Physical Performance Battery (SPPB), Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and 6-Minute Walk Test (6MWT) were compared with the Liver Frailty Index (LFI) as the method of reference. Patients with an LFI ≥ 4.5, SPPB ≤ 8, FFP ≥ 3, CFS ≥ 6 points, and those walking <250 m, were considered frail.

Results:

A total of 109 consecutive patients with stable LC were included [63.3% male, median age 62 years, (IQR 52-70), MELD 9 (7-14.5), 46.8% with decompensated LC (DC)]. PF was present in 23.9%, 27.5%, 41.3%, 13.8%, and 28.4% as assessed by the LFI, SPPB, FFP, CFS, and 6MWT, respectively. Cohen's kappa measurement of agreement of four of the tools with LFI was 0.568, 0.334, 0.439, and 0.502, respectively (p < 0.001 for each). Kaplan-Meier survival curves at 18 months showed higher mortality in frail patients compared to non-frail patients by any method (log rank p < 0.05). In the multivariate models, PF defined by any method emerged as an independent prognostic factor of 18-month mortality after adjustment for age, gender, and MELD-score.

Conclusions:

Patients characterized as frail by five screening tools were not identical. However, PF defined by either method was proven to be an independent poor prognostic factor for long-term mortality after adjustment for covariates.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Suiza