Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2021.62.8
Applicability and prognostic value of frailty assessment tools among hospitalized patients with advanced chronic liver disease
Lubomir Skladany
; Division of Hepatology, Gastroenterology, and Liver Transplantation (HEGITO), Department Internal Medicine II, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia
Zuzana Drotarova
; Division of Hepatology, Gastroenterology, and Liver Transplantation (HEGITO), Department Internal Medicine II, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia
Janka Vnencakova
; Division of Hepatology, Gastroenterology, and Liver Transplantation (HEGITO), Department Internal Medicine II, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia
Daniela Jancekova
; Division of Hepatology, Gastroenterology, and Liver Transplantation (HEGITO), Department Internal Medicine II, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia
Pavol Molcan
; Division of Hepatology, Gastroenterology, and Liver Transplantation (HEGITO), Department Internal Medicine II, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia
Tomas Koller
orcid.org/0000-0001-7418-0073
; Subdivision of Gastroenterology and Hepatology, Fifth Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava Ruzinov, Bratislava, Slovakia
Sažetak
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 inhospital, 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.
Ključne riječi
Hrčak ID:
278023
URI
Datum izdavanja:
25.2.2021.
Posjeta: 376 *