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A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis

BACKGROUND: Frailty is a syndrome that diminishes the potential for functional recovery in liver cirrhosis (LC). However, its utility is limited due to sole reliance on physical performance, especially in hospitalized patients. We investigate the predictive value of a modified self-reported Frailty...

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Autores principales: Deng, You, Lin, Lin, Hou, Lijun, Fan, Xiaofei, Zhao, Tianming, Mao, Lihong, Wang, Xiaoyu, Wang, Bangmao, Ma, Yingli, Sun, Chao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607105/
https://www.ncbi.nlm.nih.gov/pubmed/33178749
http://dx.doi.org/10.21037/atm-20-943
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author Deng, You
Lin, Lin
Hou, Lijun
Fan, Xiaofei
Zhao, Tianming
Mao, Lihong
Wang, Xiaoyu
Wang, Bangmao
Ma, Yingli
Sun, Chao
author_facet Deng, You
Lin, Lin
Hou, Lijun
Fan, Xiaofei
Zhao, Tianming
Mao, Lihong
Wang, Xiaoyu
Wang, Bangmao
Ma, Yingli
Sun, Chao
author_sort Deng, You
collection PubMed
description BACKGROUND: Frailty is a syndrome that diminishes the potential for functional recovery in liver cirrhosis (LC). However, its utility is limited due to sole reliance on physical performance, especially in hospitalized patients. We investigate the predictive value of a modified self-reported Frailty Index in cirrhotics, and identify which health deficits play more important roles. METHODS: Consecutive LC patients were assessed by our frailty scale. Outcomes of interest were mortality for 90-day, 1-year and 2-year. Independent predictors were identified by multivariate Cox regression. Receiver operating characteristic curve (ROC) was performed to evaluate discriminative ability. We used a combination of stepwise selection, best subset selection, and Akaike information criteria (AIC) to identify pivotal frailty components. RESULTS: The study cohort consisted of 158 patients, in which 37 expired during follow-up. Compared with non-frail groups, the frail group had higher 1- and 2-year mortality. The area under ROC of the Child-Turcotte-Pugh classification (CTP) and Frailty Index were 0.66 and 0.68, while 0.72 for CTP + Frailty Index (P=0.034), respectively. The optimal predictors comprised instrumental activities of daily living (IADL) limitation, falls and loss of weight (AIC =170, C-statistic =0.67). CONCLUSIONS: It is plausible for incorporating Frailty Index to improve prognostication in cirrhotics. IADL limitation, falls and loss of weight play more crucial roles on mortality determination.
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spelling pubmed-76071052020-11-10 A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis Deng, You Lin, Lin Hou, Lijun Fan, Xiaofei Zhao, Tianming Mao, Lihong Wang, Xiaoyu Wang, Bangmao Ma, Yingli Sun, Chao Ann Transl Med Original Article BACKGROUND: Frailty is a syndrome that diminishes the potential for functional recovery in liver cirrhosis (LC). However, its utility is limited due to sole reliance on physical performance, especially in hospitalized patients. We investigate the predictive value of a modified self-reported Frailty Index in cirrhotics, and identify which health deficits play more important roles. METHODS: Consecutive LC patients were assessed by our frailty scale. Outcomes of interest were mortality for 90-day, 1-year and 2-year. Independent predictors were identified by multivariate Cox regression. Receiver operating characteristic curve (ROC) was performed to evaluate discriminative ability. We used a combination of stepwise selection, best subset selection, and Akaike information criteria (AIC) to identify pivotal frailty components. RESULTS: The study cohort consisted of 158 patients, in which 37 expired during follow-up. Compared with non-frail groups, the frail group had higher 1- and 2-year mortality. The area under ROC of the Child-Turcotte-Pugh classification (CTP) and Frailty Index were 0.66 and 0.68, while 0.72 for CTP + Frailty Index (P=0.034), respectively. The optimal predictors comprised instrumental activities of daily living (IADL) limitation, falls and loss of weight (AIC =170, C-statistic =0.67). CONCLUSIONS: It is plausible for incorporating Frailty Index to improve prognostication in cirrhotics. IADL limitation, falls and loss of weight play more crucial roles on mortality determination. AME Publishing Company 2020-10 /pmc/articles/PMC7607105/ /pubmed/33178749 http://dx.doi.org/10.21037/atm-20-943 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Deng, You
Lin, Lin
Hou, Lijun
Fan, Xiaofei
Zhao, Tianming
Mao, Lihong
Wang, Xiaoyu
Wang, Bangmao
Ma, Yingli
Sun, Chao
A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis
title A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis
title_full A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis
title_fullStr A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis
title_full_unstemmed A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis
title_short A self-reported Frailty Index predicts long-term mortality in hospitalized patients with cirrhosis
title_sort self-reported frailty index predicts long-term mortality in hospitalized patients with cirrhosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607105/
https://www.ncbi.nlm.nih.gov/pubmed/33178749
http://dx.doi.org/10.21037/atm-20-943
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