Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Kaps L

PROVIDER: S-EPMC9139749 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

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

Kaps Leonard L Lukac Lejla L Michel Maurice M Kremer Wolfgang Maximilian WM Hilscher Max M Gairing Simon Johannes SJ Galle Peter R PR Galle Peter R PR Schattenberg Jörn M JM Wörns Marcus-Alexander MA Nagel Michael M Labenz Christian C

Diagnostics (Basel, Switzerland) 20220424 5

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 s ...[more]

PMID: 35626226

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Project description:BackgroundLiterature review have shown that sarcopenia substantially alters the postoperative outcomes after liver resection for malignant tumors. However, these retrospective studies do not distinguish cirrhotic and non-cirrhotic liver cancer patients, nor combine the assessment of muscle strength in addition to muscle mass. The purpose of this study is to study the relationship between sarcopenia and short-term outcomes after hepatectomy in patients with non-cirrhotic liver cancer.MethodsFrom December 2020 to October 2021, 431 consecutive inpatients were prospectively enrolled in this study. Muscle strength and mass were assessed by handgrip strength and the skeletal muscle index (SMI) on preoperative computed tomographic scans, respectively. Based on the SMI and the handgrip strength, patients were divided into four groups: group A (low muscle mass and strength), group B (low muscle mass and normal muscle strength), group C (low muscle strength and normal muscle mass), and group D (normal muscle mass and strength). The main outcome was major complications and the secondary outcome was 90-d Readmission rate.ResultsAfter strictly exclusion, 171 non-cirrhosis patients (median age, 59.00 [IQR, 50.00-67.00] years; 72 females [42.1%]) were selected in the final analysis. Patients in group A had a statistically significantly higher incidence of major postoperative complications (Clavien-Dindo classification ≥ III) (26.1%, p = 0.032), blood transfusion rate (65.2%, p < 0.001), 90-day readmission rate (21.7%, p = 0.037) and hospitalization expenses (60,842.00 [IQR, 35,563.10-87,575.30], p < 0.001) than other groups. Sarcopenia (hazard ratio, 4.21; 95% CI, 1.44-9.48; p = 0.025) and open approach (hazard ratio, 2.56; 95% CI, 1.01-6.49; p = 0.004) were independent risk factors associated with major postoperative complications.ConclusionsSarcopenia is closely related to poor short-term postoperative outcomes in non-cirrhosis liver cancer patients and the assessment that combines muscle strength and muscle mass can simply and comprehensively identify it.Trial registrationClinicalTrials.gov identifiers NCT04637048 . (19/11/2020).

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Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

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