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Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis

Background: Stratifying patients with liver cirrhosis for risk of rehospitalization is challenging with established scoring systems for chronic liver disease. Frailty captures the physical characteristics of patients with cirrhosis. Its value for predicting short-term rehospitalizations in hospitali...

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Autores principales: Kaps, Leonard, Lukac, Lejla, Michel, Maurice, Kremer, Wolfgang Maximilian, Hilscher, Max, Gairing, Simon Johannes, Galle, Peter R., Schattenberg, Jörn M., Wörns, Marcus-Alexander, Nagel, Michael, Labenz, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9139749/
https://www.ncbi.nlm.nih.gov/pubmed/35626226
http://dx.doi.org/10.3390/diagnostics12051069
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author Kaps, Leonard
Lukac, Lejla
Michel, Maurice
Kremer, Wolfgang Maximilian
Hilscher, Max
Gairing, Simon Johannes
Galle, Peter R.
Schattenberg, Jörn M.
Wörns, Marcus-Alexander
Nagel, Michael
Labenz, Christian
author_facet Kaps, Leonard
Lukac, Lejla
Michel, Maurice
Kremer, Wolfgang Maximilian
Hilscher, Max
Gairing, Simon Johannes
Galle, Peter R.
Schattenberg, Jörn M.
Wörns, Marcus-Alexander
Nagel, Michael
Labenz, Christian
author_sort Kaps, Leonard
collection PubMed
description Background: Stratifying patients with liver cirrhosis for risk of rehospitalization is challenging with established scoring systems for chronic liver disease. Frailty captures the physical characteristics of patients with cirrhosis. Its value for predicting short-term rehospitalizations in hospitalized patients remains to be defined. Methods: Eighty-three non-electively hospitalized patients with liver cirrhosis were analyzed in this study. Frailty was assessed during the last 48 h of hospital stay with the liver frailty index (LFI). Patients were followed for 30-day rehospitalization. Results: In total, 26 (31%) patients were rehospitalized within 30 days. The median LFI was 4.5, and 43 (52%) patients were identified as frail. Rehospitalized patients had a significant higher LFI compared to patients without a rehospitalization within 30 days. In multivariable analysis, LFI as a metric variable (OR 2.36, p = 0.02) and lower platelet count (OR 0.98, p < 0.01) were independently associated with rehospitalization. LFI and its subtest chair stands had the best discriminative ability to predict rehospitalization, with AUROCs of 0.66 and 0.67, respectively. An LFI cut-off of >4.62 discriminated best between patients with and without elevated risk for rehospitalization within 30 days. Conclusions: Measures of frailty could be useful to identify patients at higher risk for short-term rehospitalization.
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spelling pubmed-91397492022-05-28 Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis Kaps, Leonard Lukac, Lejla Michel, Maurice Kremer, Wolfgang Maximilian Hilscher, Max Gairing, Simon Johannes Galle, Peter R. Schattenberg, Jörn M. Wörns, Marcus-Alexander Nagel, Michael Labenz, Christian Diagnostics (Basel) Article Background: Stratifying patients with liver cirrhosis for risk of rehospitalization is challenging with established scoring systems for chronic liver disease. Frailty captures the physical characteristics of patients with cirrhosis. Its value for predicting short-term rehospitalizations in hospitalized patients remains to be defined. Methods: Eighty-three non-electively hospitalized patients with liver cirrhosis were analyzed in this study. Frailty was assessed during the last 48 h of hospital stay with the liver frailty index (LFI). Patients were followed for 30-day rehospitalization. Results: In total, 26 (31%) patients were rehospitalized within 30 days. The median LFI was 4.5, and 43 (52%) patients were identified as frail. Rehospitalized patients had a significant higher LFI compared to patients without a rehospitalization within 30 days. In multivariable analysis, LFI as a metric variable (OR 2.36, p = 0.02) and lower platelet count (OR 0.98, p < 0.01) were independently associated with rehospitalization. LFI and its subtest chair stands had the best discriminative ability to predict rehospitalization, with AUROCs of 0.66 and 0.67, respectively. An LFI cut-off of >4.62 discriminated best between patients with and without elevated risk for rehospitalization within 30 days. Conclusions: Measures of frailty could be useful to identify patients at higher risk for short-term rehospitalization. MDPI 2022-04-24 /pmc/articles/PMC9139749/ /pubmed/35626226 http://dx.doi.org/10.3390/diagnostics12051069 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kaps, Leonard
Lukac, Lejla
Michel, Maurice
Kremer, Wolfgang Maximilian
Hilscher, Max
Gairing, Simon Johannes
Galle, Peter R.
Schattenberg, Jörn M.
Wörns, Marcus-Alexander
Nagel, Michael
Labenz, Christian
Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis
title Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis
title_full Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis
title_fullStr Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis
title_full_unstemmed Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis
title_short Liver Frailty Index for Prediction of Short-Term Rehospitalization in Patients with Liver Cirrhosis
title_sort liver frailty index for prediction of short-term rehospitalization in patients with liver cirrhosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9139749/
https://www.ncbi.nlm.nih.gov/pubmed/35626226
http://dx.doi.org/10.3390/diagnostics12051069
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