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Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease

AIM: To assess and compare the feasibility and prognostic value of various frailty assessment tools among decompensated cirrhosis inpatients. METHODS: Our prospective observational registry included consecutive patients admitted for cirrhosis between June 2017 and July 2018. Exclusion criteria were...

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Autores principales: Skladany, Lubomir, Drotarova, Zuzana, Vnencakova, Janka, Jancekova, Daniela, Molcan, Pavol, Koller, Tomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Croatian Medical Schools 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976891/
https://www.ncbi.nlm.nih.gov/pubmed/33660956
http://dx.doi.org/10.3325/cmj.2021.62.8
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author Skladany, Lubomir
Drotarova, Zuzana
Vnencakova, Janka
Jancekova, Daniela
Molcan, Pavol
Koller, Tomas
author_facet Skladany, Lubomir
Drotarova, Zuzana
Vnencakova, Janka
Jancekova, Daniela
Molcan, Pavol
Koller, Tomas
author_sort Skladany, Lubomir
collection PubMed
description AIM: To assess and compare the feasibility and prognostic value of various frailty assessment tools among decompensated cirrhosis inpatients. METHODS: Our prospective observational registry included consecutive patients admitted for cirrhosis between June 2017 and July 2018. Exclusion criteria were intensive-care unit admission, hepatocellular carcinoma outside of the Milan criteria, and other malignancies. Frailty at baseline was assessed with the Liver Frailty Index (LFI), Clinical Frailty Scale (CFS), Fried Frailty Score (FFS), and Short Physical Performance Battery test (SPPB). The follow-up lasted for at least 180 days. RESULTS: The study enrolled 168 patients (35.1% women, median age 57.9 years). The most frequent primary etiology was alcohol-related liver disease (78.6%). The Median Model for End-Stage Liver Disease (MELD) was 16. The 80th percentile of frailty scores was LFI>5.4, CFS>4, FFS>3, and SPPB<5, and it identified patients with higher mortality. LFI and CFS had the highest numerical prognostic value for in-hospital, and 90- and 180-day mortality. In a bivariate analysis of the risk of death or liver transplantation, the combination of MELD and LFI had the highest concordance (0.771 ± 0.04). In a multivariate model, MELD score (HR 1.17, 95% CI 1.12-1.22), overt encephalopathy (2.39, 1.27-4.48), infection at baseline (2.32, 1.23-4.34), and numerical LFI (1.41, 1.02-1.95) were independent predictors of overall mortality. CONCLUSION: Frailty assessment using the evaluated tools is feasible among hospitalized cirrhotic patients, identifying those with worse prognosis. CFS had the highest applicability and accuracy for the initial assessment and LFI for the initial and follow-up assessments.
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spelling pubmed-79768912021-03-31 Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease Skladany, Lubomir Drotarova, Zuzana Vnencakova, Janka Jancekova, Daniela Molcan, Pavol Koller, Tomas Croat Med J Research Article AIM: To assess and compare the feasibility and prognostic value of various frailty assessment tools among decompensated cirrhosis inpatients. METHODS: Our prospective observational registry included consecutive patients admitted for cirrhosis between June 2017 and July 2018. Exclusion criteria were intensive-care unit admission, hepatocellular carcinoma outside of the Milan criteria, and other malignancies. Frailty at baseline was assessed with the Liver Frailty Index (LFI), Clinical Frailty Scale (CFS), Fried Frailty Score (FFS), and Short Physical Performance Battery test (SPPB). The follow-up lasted for at least 180 days. RESULTS: The study enrolled 168 patients (35.1% women, median age 57.9 years). The most frequent primary etiology was alcohol-related liver disease (78.6%). The Median Model for End-Stage Liver Disease (MELD) was 16. The 80th percentile of frailty scores was LFI>5.4, CFS>4, FFS>3, and SPPB<5, and it identified patients with higher mortality. LFI and CFS had the highest numerical prognostic value for in-hospital, and 90- and 180-day mortality. In a bivariate analysis of the risk of death or liver transplantation, the combination of MELD and LFI had the highest concordance (0.771 ± 0.04). In a multivariate model, MELD score (HR 1.17, 95% CI 1.12-1.22), overt encephalopathy (2.39, 1.27-4.48), infection at baseline (2.32, 1.23-4.34), and numerical LFI (1.41, 1.02-1.95) were independent predictors of overall mortality. CONCLUSION: Frailty assessment using the evaluated tools is feasible among hospitalized cirrhotic patients, identifying those with worse prognosis. CFS had the highest applicability and accuracy for the initial assessment and LFI for the initial and follow-up assessments. Croatian Medical Schools 2021-02 /pmc/articles/PMC7976891/ /pubmed/33660956 http://dx.doi.org/10.3325/cmj.2021.62.8 Text en Copyright © 2021 by the Croatian Medical Journal. All rights reserved. http://creativecommons.org/licenses/by/2.5/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Skladany, Lubomir
Drotarova, Zuzana
Vnencakova, Janka
Jancekova, Daniela
Molcan, Pavol
Koller, Tomas
Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
title Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
title_full Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
title_fullStr Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
title_full_unstemmed Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
title_short Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
title_sort applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976891/
https://www.ncbi.nlm.nih.gov/pubmed/33660956
http://dx.doi.org/10.3325/cmj.2021.62.8
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