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Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis
INTRODUCTION: Frailty is a common but often underestimated complication in patients with liver cirrhosis. The Clinical Frailty Scale (CFS) allows the assessment of frailty within a short period of time but has only been investigated in a Canadian cohort of outpatients. The aim of the current study w...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386350/ https://www.ncbi.nlm.nih.gov/pubmed/32764204 http://dx.doi.org/10.14309/ctg.0000000000000211 |
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author | Kremer, Wolfgang M. Nagel, Michael Reuter, Michael Hilscher, Max Michel, Maurice Kaps, Leonard Labenz, Joachim Galle, Peter R. Sprinzl, Martin F. Wörns, Marcus-Alexander Labenz, Christian |
author_facet | Kremer, Wolfgang M. Nagel, Michael Reuter, Michael Hilscher, Max Michel, Maurice Kaps, Leonard Labenz, Joachim Galle, Peter R. Sprinzl, Martin F. Wörns, Marcus-Alexander Labenz, Christian |
author_sort | Kremer, Wolfgang M. |
collection | PubMed |
description | INTRODUCTION: Frailty is a common but often underestimated complication in patients with liver cirrhosis. The Clinical Frailty Scale (CFS) allows the assessment of frailty within a short period of time but has only been investigated in a Canadian cohort of outpatients. The aim of the current study was to evaluate the ability of the CFS to predict mortality in outpatients and nonelectively hospitalized German patients. METHODS: Two hundred outpatients and 99 nonelectively hospitalized patients with liver cirrhosis were prospectively enrolled. Outpatients/inpatients were followed for a median of 364/28 days regarding the primary outcome of death or liver transplantation. Eighty-seven patients of the outpatient cohort and 64 patients of the inpatient cohort had available computed tomography-scans for the quantification of muscle mass. RESULTS: Median CFS was 3 in the outpatient and the inpatient cohort. Twenty-one (10.5%) outpatients were at least prefrail (CFS > 3) and 26 (26.3%) inpatients were frail (CFS > 4). For every one-unit increase, there was an independent association between the CFS and mortality in the outpatient cohort (hazard ratio 1.534, P = 0.007). This association remained significant after controlling for muscle mass in the subcohort with available computed tomography scans. In the inpatient cohort, frailty (CFS > 4) was an independent predictor for 28-day mortality after controlling for acute-on-chronic liver failure, albumin, and infections (odds ratio 4.627, P = 0.045). However, this association did not reach significance in a subcohort after controlling for muscle mass. DISCUSSION: Especially in outpatients, CFS is a useful predictor regarding increased mortality independent of the muscle mass. |
format | Online Article Text |
id | pubmed-7386350 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer |
record_format | MEDLINE/PubMed |
spelling | pubmed-73863502020-08-05 Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis Kremer, Wolfgang M. Nagel, Michael Reuter, Michael Hilscher, Max Michel, Maurice Kaps, Leonard Labenz, Joachim Galle, Peter R. Sprinzl, Martin F. Wörns, Marcus-Alexander Labenz, Christian Clin Transl Gastroenterol Article INTRODUCTION: Frailty is a common but often underestimated complication in patients with liver cirrhosis. The Clinical Frailty Scale (CFS) allows the assessment of frailty within a short period of time but has only been investigated in a Canadian cohort of outpatients. The aim of the current study was to evaluate the ability of the CFS to predict mortality in outpatients and nonelectively hospitalized German patients. METHODS: Two hundred outpatients and 99 nonelectively hospitalized patients with liver cirrhosis were prospectively enrolled. Outpatients/inpatients were followed for a median of 364/28 days regarding the primary outcome of death or liver transplantation. Eighty-seven patients of the outpatient cohort and 64 patients of the inpatient cohort had available computed tomography-scans for the quantification of muscle mass. RESULTS: Median CFS was 3 in the outpatient and the inpatient cohort. Twenty-one (10.5%) outpatients were at least prefrail (CFS > 3) and 26 (26.3%) inpatients were frail (CFS > 4). For every one-unit increase, there was an independent association between the CFS and mortality in the outpatient cohort (hazard ratio 1.534, P = 0.007). This association remained significant after controlling for muscle mass in the subcohort with available computed tomography scans. In the inpatient cohort, frailty (CFS > 4) was an independent predictor for 28-day mortality after controlling for acute-on-chronic liver failure, albumin, and infections (odds ratio 4.627, P = 0.045). However, this association did not reach significance in a subcohort after controlling for muscle mass. DISCUSSION: Especially in outpatients, CFS is a useful predictor regarding increased mortality independent of the muscle mass. Wolters Kluwer 2020-07-21 /pmc/articles/PMC7386350/ /pubmed/32764204 http://dx.doi.org/10.14309/ctg.0000000000000211 Text en © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Kremer, Wolfgang M. Nagel, Michael Reuter, Michael Hilscher, Max Michel, Maurice Kaps, Leonard Labenz, Joachim Galle, Peter R. Sprinzl, Martin F. Wörns, Marcus-Alexander Labenz, Christian Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis |
title | Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis |
title_full | Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis |
title_fullStr | Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis |
title_full_unstemmed | Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis |
title_short | Validation of the Clinical Frailty Scale for the Prediction of Mortality in Patients With Liver Cirrhosis |
title_sort | validation of the clinical frailty scale for the prediction of mortality in patients with liver cirrhosis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386350/ https://www.ncbi.nlm.nih.gov/pubmed/32764204 http://dx.doi.org/10.14309/ctg.0000000000000211 |
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