Duke Activity Status Index and Liver Frailty Index predict mortality in ambulatory patients with advanced chronic liver disease: A prospective, observational study

被引：9

作者：

Williams, Felicity R. ^{[1
,2
,3
,4
,9
]}

Quinlan, Jonathan ^{[1
,2
,3
]}

Freer, Alice ^{[5
]}

Morrison, Breanna ^{[6
]}

Sitch, Alice ^{[1
,2
,6
]}

Hockey, Florence ^{[7
]}

Klas, Natasza ^{[7
]}

Towey, Jennifer ^{[5
]}

Perera, Thamara P. R. ^{[4
]}

Rajoriya, Neil ^{[1
,4
]}

Lord, Janet M. ^{[1
,2
,8
]}

Armstrong, Matthew J. ^{[1
,2
,4
,9
]}

机构：

[1] Univ Hosp Birmingham NHS Fdn Trust, NIHR Birmingham Biomed Res Ctr, Birmingham, W Midlands, England

[2] Univ Birmingham, Birmingham, Warwickshire, England

[3] Univ Birmingham, Sch Sports Exercise & Rehabil Sci, Birmingham, England

[4] Queen Elizabeth Univ Hosp Birmingham, Liver Transplant Unit, Birmingham, England

[5] Queen Elizabeth Univ Hosp Birmingham, Therapies Dept, Birmingham, Warwickshire, England

[6] Univ Birmingham, Inst Appl Hlth Res, Birmingham, Warwickshire, England

[7] Univ Birmingham, Med & Dent Sch, Birmingham, Warwickshire, England

[8] Univ Birmingham, Inst Inflammat & Ageing, Birmingham, Warwickshire, England

[9] Queen Elizabeth Univ Hosp Birmingham, Liver Transplant Unit, 3rd Floor Nuffield House, Mindelsohn Way, Birmingham B15 2TH, Warwickshire, England

来源：

ALIMENTARY PHARMACOLOGY & THERAPEUTICS | 2024年 / 59卷 / 04期

关键词：

HEPATIC-ENCEPHALOPATHY; FUNCTIONAL-CAPACITY; SARCOPENIA; SURVIVAL;

D O I：

10.1111/apt.17834

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundThere remains a lack of consensus on how to assess functional exercise capacity and physical frailty in patients with advanced chronic liver disease (CLD) being assessed for liver transplantation (LT). Aim To investigate prospectively the utility of the Duke Activity Status Index (DASI) and Liver Frailty Index (LFI) in ambulatory patients with CLD.AimTo investigate prospectively the utility of the Duke Activity Status Index (DASI) and Liver Frailty Index (LFI) in ambulatory patients with CLD.MethodsWe recruited patients from outpatient clinics at University Hospitals Birmingham, UK (2018-2019). We prospectively collated the DASI and LFI to identify the prevalence of, respectively, functional capacity and physical frailty, and to evaluate their accuracy in predicting overall and pre-LT mortality.ResultsWe studied 307 patients (57% male; median age 54 years; UKELD 52). Median DASI score was 28.7 (IQR 16.2-50.2), mean LFI was 3.82 (SD = 0.72), and 81% were defined either 'pre-frail' or 'frail'. Female sex and hyponatraemia were significant independent predictors of both DASI and LFI. Age and encephalopathy were significant independent predictors of LFI, while BMI significantly predicted DASI. DASI and LFI were significantly related to overall (HR 0.97, p = 0.001 [DASI], HR 2.04, p = 0.001 [LFI]) and pre-LT mortality (HR 0.96, p = 0.02 [DASI], HR 1.94, p = 0.04 [LFI]).ConclusionsPoor functional exercise capacity and physical frailty are highly prevalent among ambulatory patients with CLD who are being assessed for LT. The DASI and LFI are simple, low-cost tools that predict overall and pre-LT mortality. Implementation of both should be considered in all outpatients with CLD to highlight those who may benefit from targeted nutritional and exercise interventions. imagePhysical frailty and functional capacity predict all-cause and waiting list mortality in patients assessed for liver transplantation. The findings of a prospective, observational study of 307 patients with chronic liver disease. Key - BMI, body mass index; DASI, duke activity status index; LFI, liver frailty index; LT, Liver Transplantation; UK, United Kingdom; US, United States.

引用

页码：547 / 557

页数：11

共 29 条

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