Cargando…

Beta-blockers and physical frailty in patients with end-stage liver disease

AIM: To investigate beta-blocker (BB) use in patients with cirrhosis and determine their effects on physical frailty and overall survival. METHODS: Adult outpatients with cirrhosis listed for liver transplantation underwent testing of physical frailty using the performance-based Liver Frailty Index,...

Descripción completa

Detalles Bibliográficos
Autores principales: Kuo, Selena Z, Lizaola, Blanca, Hayssen, Hilary, Lai, Jennifer C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127661/
https://www.ncbi.nlm.nih.gov/pubmed/30197482
http://dx.doi.org/10.3748/wjg.v24.i33.3770
_version_ 1783353521561665536
author Kuo, Selena Z
Lizaola, Blanca
Hayssen, Hilary
Lai, Jennifer C
author_facet Kuo, Selena Z
Lizaola, Blanca
Hayssen, Hilary
Lai, Jennifer C
author_sort Kuo, Selena Z
collection PubMed
description AIM: To investigate beta-blocker (BB) use in patients with cirrhosis and determine their effects on physical frailty and overall survival. METHODS: Adult outpatients with cirrhosis listed for liver transplantation underwent testing of physical frailty using the performance-based Liver Frailty Index, comprised of chair stands, grip strength, and balance testing, as well as self-reported assessments of exhaustion and physical activity. BB use was assessed from medical chart review. Univariable and multivariable logistic regression were performed to determine BB use and their association with measures of physical frailty. Competing risk analyses were performed to determine the effect of BB use on wait-list mortality, as defined by death or delisting for being too sick for transplant. RESULTS: Of 344 patients, 35% were female, median age was 60, median model for end stage liver disease was 15, and 53% were prescribed a BB. Compared to those not on BB, patients on BB were similar except for percentage female (25% vs 46%; P < 0.001) and BMI (29 vs 28; P = 0.008). With respect to tests of physical frailty, BB use was not associated with increased odds of frailty (by the Liver Frailty Index), exhaustion, or low physical activity. BB use was, however, significantly associated with a decreased adjusted risk of mortality (SHR 0.55; P = 0.005). CONCLUSION: In patients with cirrhosis awaiting liver transplantation, BB use is not associated with physical frailty. We confirmed the known survival benefits with BB use, and concerns about adverse effects should not deter their utilization when indicated.
format Online
Article
Text
id pubmed-6127661
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-61276612018-09-07 Beta-blockers and physical frailty in patients with end-stage liver disease Kuo, Selena Z Lizaola, Blanca Hayssen, Hilary Lai, Jennifer C World J Gastroenterol Retrospective Cohort Study AIM: To investigate beta-blocker (BB) use in patients with cirrhosis and determine their effects on physical frailty and overall survival. METHODS: Adult outpatients with cirrhosis listed for liver transplantation underwent testing of physical frailty using the performance-based Liver Frailty Index, comprised of chair stands, grip strength, and balance testing, as well as self-reported assessments of exhaustion and physical activity. BB use was assessed from medical chart review. Univariable and multivariable logistic regression were performed to determine BB use and their association with measures of physical frailty. Competing risk analyses were performed to determine the effect of BB use on wait-list mortality, as defined by death or delisting for being too sick for transplant. RESULTS: Of 344 patients, 35% were female, median age was 60, median model for end stage liver disease was 15, and 53% were prescribed a BB. Compared to those not on BB, patients on BB were similar except for percentage female (25% vs 46%; P < 0.001) and BMI (29 vs 28; P = 0.008). With respect to tests of physical frailty, BB use was not associated with increased odds of frailty (by the Liver Frailty Index), exhaustion, or low physical activity. BB use was, however, significantly associated with a decreased adjusted risk of mortality (SHR 0.55; P = 0.005). CONCLUSION: In patients with cirrhosis awaiting liver transplantation, BB use is not associated with physical frailty. We confirmed the known survival benefits with BB use, and concerns about adverse effects should not deter their utilization when indicated. Baishideng Publishing Group Inc 2018-09-07 2018-09-07 /pmc/articles/PMC6127661/ /pubmed/30197482 http://dx.doi.org/10.3748/wjg.v24.i33.3770 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Kuo, Selena Z
Lizaola, Blanca
Hayssen, Hilary
Lai, Jennifer C
Beta-blockers and physical frailty in patients with end-stage liver disease
title Beta-blockers and physical frailty in patients with end-stage liver disease
title_full Beta-blockers and physical frailty in patients with end-stage liver disease
title_fullStr Beta-blockers and physical frailty in patients with end-stage liver disease
title_full_unstemmed Beta-blockers and physical frailty in patients with end-stage liver disease
title_short Beta-blockers and physical frailty in patients with end-stage liver disease
title_sort beta-blockers and physical frailty in patients with end-stage liver disease
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127661/
https://www.ncbi.nlm.nih.gov/pubmed/30197482
http://dx.doi.org/10.3748/wjg.v24.i33.3770
work_keys_str_mv AT kuoselenaz betablockersandphysicalfrailtyinpatientswithendstageliverdisease
AT lizaolablanca betablockersandphysicalfrailtyinpatientswithendstageliverdisease
AT hayssenhilary betablockersandphysicalfrailtyinpatientswithendstageliverdisease
AT laijenniferc betablockersandphysicalfrailtyinpatientswithendstageliverdisease