Frailty in outpatients with cirrhosis: A prospective observational study
Por:
Roman, E, Parramon, M, Flavia, M, Gely, C, Poca, M, Gallego, A, Santesmases, R, Hernandez, E, Nieto, JC, Urgell, E, Alvarado-Tapias, E, Vidal, S, Ferrero-Gregori, A, Vargas, V, Guarner, C, Soriano, G
Publicada:
1 feb 2021
Ahead of Print:
1 oct 2020
Resumen:
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.
Filiaciones:
Roman, E:
Escola Univ Infermeria EUI St Pau, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Mas Casanovas,90, Barcelona 08041, Spain
Inst Salud Carlos III, CIBERehd, Madrid, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Parramon, M:
Primary Care Ctr Passeig Maragall, Barcelona, Spain
Flavia, M:
Hosp Valle De Hebron, Liver Unit, Barcelona, Spain
Gely, C:
Res Inst IIB St Pau, Barcelona, Spain
Poca, M:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Mas Casanovas,90, Barcelona 08041, Spain
Inst Salud Carlos III, CIBERehd, Madrid, Spain
Gallego, A:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Mas Casanovas,90, Barcelona 08041, Spain
Santesmases, R:
Escola Univ Infermeria EUI St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Hernandez, E:
Escola Univ Infermeria EUI St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Nieto, JC:
Res Inst IIB St Pau, Barcelona, Spain
Urgell, E:
Dept Biochem, Barcelona, Spain
Alvarado-Tapias, E:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Mas Casanovas,90, Barcelona 08041, Spain
Inst Salud Carlos III, CIBERehd, Madrid, Spain
Res Inst IIB St Pau, Barcelona, Spain
Vidal, S:
Univ Autonoma Barcelona, Barcelona, Spain
Res Inst IIB St Pau, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Immunol, Barcelona, Spain
Ferrero-Gregori, A:
INCLIVA Hlth Res Inst, Valencia, Spain
Fdn Promot Hlth & Biomed Res Valencia Reg FISABIO, Valencia, Spain
Inst Salud Carlos III, CIBERCV, Madrid, Spain
Vargas, V:
Inst Salud Carlos III, CIBERehd, Madrid, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Hosp Valle De Hebron, Liver Unit, Barcelona, Spain
Guarner, C:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Mas Casanovas,90, Barcelona 08041, Spain
Inst Salud Carlos III, CIBERehd, Madrid, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Soriano, G:
Hosp Santa Creu & Sant Pau, Dept Gastroenterol, Mas Casanovas,90, Barcelona 08041, Spain
Inst Salud Carlos III, CIBERehd, Madrid, Spain
Univ Autonoma Barcelona, Barcelona, Spain
|