This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Open AccessArticle
Evaluation of Five Screening Tools in Detecting Physical Frailty in Cirrhosis and Their Prognostic Role
by
Eleni Geladari
Eleni Geladari 1,
Theodoros Alexopoulos
Theodoros Alexopoulos 2,
Larisa Vasilieva
Larisa Vasilieva 3,
Roxane Tenta
Roxane Tenta 4
,
Iliana Mani
Iliana Mani 5,
Vassilios Sevastianos
Vassilios Sevastianos 1 and
Alexandra Alexopoulou
Alexandra Alexopoulou 5,*
1
3rd Department of Internal Medicine and Liver Outpatient Clinic, Evangelismos General Hospital, 10676 Athens, Greece
2
Gastroenterology Department, Medical School, Laiko General Hospital, National & Kapodistrian University of Athens, 11527 Athens, Greece
3
Department of Gastroenterology, Alexandra General Hospital, 11528 Athens, Greece
4
Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece
5
2nd Department of Internal Medicine and Research Laboratory, Medical School, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(17), 5169; https://doi.org/10.3390/jcm13175169 (registering DOI)
Submission received: 11 July 2024
/
Revised: 12 August 2024
/
Accepted: 27 August 2024
/
Published: 30 August 2024
Abstract
Background: Physical frailty (PF) is a syndrome of decreased physical function and reserves, preventing patients from coping with stressful events. PF screening tools in patients with liver cirrhosis (LC) can help evaluate the risk of complications and death. The aim of this study was to assess the performance of five screening tools in detecting PF and their ability to predict 18-month mortality in LC. Methods: The Short Physical Performance Battery (SPPB), Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and 6-Minute Walk Test (6MWT) were compared with the Liver Frailty Index (LFI) as the method of reference. Patients with an LFI ≥ 4.5, SPPB ≤ 8, FFP ≥ 3, CFS ≥ 6 points, and those walking <250 m, were considered frail. Results: A total of 109 consecutive patients with stable LC were included [63.3% male, median age 62 years, (IQR 52–70), MELD 9 (7–14.5), 46.8% with decompensated LC (DC)]. PF was present in 23.9%, 27.5%, 41.3%, 13.8%, and 28.4% as assessed by the LFI, SPPB, FFP, CFS, and 6MWT, respectively. Cohen’s kappa measurement of agreement of four of the tools with LFI was 0.568, 0.334, 0.439, and 0.502, respectively (p < 0.001 for each). Kaplan–Meier survival curves at 18 months showed higher mortality in frail patients compared to non-frail patients by any method (log rank p < 0.05). In the multivariate models, PF defined by any method emerged as an independent prognostic factor of 18-month mortality after adjustment for age, gender, and MELD-score. Conclusions: Patients characterized as frail by five screening tools were not identical. However, PF defined by either method was proven to be an independent poor prognostic factor for long-term mortality after adjustment for covariates.
Share and Cite
MDPI and ACS Style
Geladari, E.; Alexopoulos, T.; Vasilieva, L.; Tenta, R.; Mani, I.; Sevastianos, V.; Alexopoulou, A.
Evaluation of Five Screening Tools in Detecting Physical Frailty in Cirrhosis and Their Prognostic Role. J. Clin. Med. 2024, 13, 5169.
https://doi.org/10.3390/jcm13175169
AMA Style
Geladari E, Alexopoulos T, Vasilieva L, Tenta R, Mani I, Sevastianos V, Alexopoulou A.
Evaluation of Five Screening Tools in Detecting Physical Frailty in Cirrhosis and Their Prognostic Role. Journal of Clinical Medicine. 2024; 13(17):5169.
https://doi.org/10.3390/jcm13175169
Chicago/Turabian Style
Geladari, Eleni, Theodoros Alexopoulos, Larisa Vasilieva, Roxane Tenta, Iliana Mani, Vassilios Sevastianos, and Alexandra Alexopoulou.
2024. "Evaluation of Five Screening Tools in Detecting Physical Frailty in Cirrhosis and Their Prognostic Role" Journal of Clinical Medicine 13, no. 17: 5169.
https://doi.org/10.3390/jcm13175169
Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details
here.
Article Metrics
Article Access Statistics
For more information on the journal statistics, click
here.
Multiple requests from the same IP address are counted as one view.