Frailty in outpatients with cirrhosis: A prospective observational study.

Autor: Román E; Escola Universitària d'Infermeria EUI-Sant Pau, Barcelona, Spain.; Department of Gastroenterology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain., Parramón M; Primary Care Center Passeig Maragall, Barcelona, Spain., Flavià M; Liver Unit, Hospital Vall d'Hebron, Barcelona, Spain., Gely C; Research Institute IIB-Sant Pau, Barcelona, Spain., Poca M; Department of Gastroenterology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain., Gallego A; Department of Gastroenterology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Santesmases R; Escola Universitària d'Infermeria EUI-Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain., Hernández E; Escola Universitària d'Infermeria EUI-Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain., Nieto JC; Research Institute IIB-Sant Pau, Barcelona, Spain., Urgell E; Department of Biochemistry, Barcelona, Spain., Alvarado-Tapias E; Department of Gastroenterology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.; Research Institute IIB-Sant Pau, Barcelona, Spain., Vidal S; Universitat Autònoma de Barcelona, Barcelona, Spain.; Research Institute IIB-Sant Pau, Barcelona, Spain.; Department of Immunology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Ferrero-Gregori A; INCLIVA Health Research Institute, Valencia, Spain.; Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain.; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain., Vargas V; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain.; Liver Unit, Hospital Vall d'Hebron, Barcelona, Spain., Guarner C; Department of Gastroenterology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain., Soriano G; Department of Gastroenterology at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2021 Feb; Vol. 41 (2), pp. 357-368. Date of Electronic Publication: 2020 Oct 29.
DOI: 10.1111/liv.14694
Abstrakt: Background and Aim: Frailty is increasingly recognized as a major prognostic factor in cirrhosis in addition to conventional liver insufficiency scores. The aim was to compare the prevalence and characteristics of frailty between patients with cirrhosis and controls, and to analyse its prognostic value.
Methods: We included outpatients with cirrhosis and age- and gender-matched non-cirrhotic controls. Frailty was defined according to the Fried frailty criteria. In patients with cirrhosis, we analysed the ability of the degree of frailty to predict a composite endpoint, consisting of hospitalization, admission to a long-term care centre, falls or death.
Results: We included 135 patients with cirrhosis and 135 controls. The prevalence of frailty was higher among patients with cirrhosis: 35 (25.9%) frail, 74 (54.8%) pre-frail and 26 (19.2%) robust vs 14 (10.4%) frail, 67 (49.6%) pre-frail and 54 (40%) robust (P < .001) in controls. This difference was mainly as a result of decreased muscle strength in patients with cirrhosis. During follow-up, frail patients with cirrhosis showed a higher probability of composite endpoint, hospitalization and falls than pre-frail and robust cirrhotic patients but mortality was similar. MELD-Na score and frailty were independent predictive factors for hospitalization, frailty for falls, and MELD-Na score and albumin for survival. Vitamin D deficiency and increased cystatin C were associated with frailty.
Conclusions: Frailty was more frequent in outpatients with cirrhosis than in controls, mainly because of a decrease in muscle strength, and it could be a predictive factor for hospitalization and falls in these patients.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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