Comprehensive Frailty Severity Index for End-Stage Liver Disease Predicts Early Outcomes After Liver Transplantation
| Autor: | Jared Mahan, Molly Bowdon-Romero, Joshua Livingstone, Yehuda Raveh, Gennaro Selvaggi, Ramona Nicolau-Raducu, Akin Tekin |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030309 nutrition & dietetics medicine.medical_treatment Medicine (miscellaneous) Nutritional Status Liver transplantation End Stage Liver Disease 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine Medicine Humans Mass index 0303 health sciences Nutrition and Dietetics Karnofsky Performance Status Frailty business.industry Liver Diseases End stage liver disease medicine.disease Liver Transplantation Malnutrition Parenteral nutrition Physical performance 030211 gastroenterology & hepatology business |
| Zdroj: | JPEN. Journal of parenteral and enteral nutritionReferences. 44(6) |
| ISSN: | 1941-2444 |
| Popis: | Background Frailty is rampant in candidates of liver transplantation (LT); however, its impact on posttransplant survival is inconclusive. Most studies have used a single measure of frailty; however, a comprehensive frailty severity index (FSI) has not been developed. The objectives of this study were to (1) evaluate frailty utilizing several metrics, (2) develop an FSI for end-stage liver disease (ESLD), and (3) determine its predictive abilities for outcomes after LT. Methods Frailty metrics included (1) modified nutrition assessment of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition that includes height-adjusted third lumbar vertebra psoas mass index, (2) physical performance assessment combining Karnofsky Performance Status and pressure injury scale, and (3) Controlling Nutritional Status as a measure of severity of liver disease and inflammation. Results Moderate to severe frailty was reported in 52%-97% of recipients depending on the metric. A statistically significant threshold FSI value was identified for each adverse outcome studied. FSI ≥ 14 was associated with decreased survival (88% vs 97% for FSI Conclusions The proposed FSI for ESLD is predictive of poorer outcomes after LT. |
| Databáze: | OpenAIRE |
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