Frailty in advanced liver disease

Frailty in advanced liver disease.

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Item Type: Article
Status: Published
Official URL:
Journal or Publication Title: Liver International
Volume: 38
Number: 12
Page Range: pp. 2117-2128
Date: 2018
Divisions: Liver Injury and Cancer
Depositing User: General Admin
Identification Number: 10.1111/liv.13917
ISSN: 14783223
Date Deposited: 04 Jan 2021 04:25

Prognostication of patients with cirrhosis is complex, depending on more than just the severity of liver disease. Scores such as the model for end‐stage liver disease (MELD) and Child Pugh can assist with prognostication, yet by focusing on physiological parameters they fail to completely capture the elements contributing to a patient's clinical status. Evidence is increasing to support an important role for physical functioning in patient outcomes. Frailty has been increasingly recognised in medical literature over recent years, including in hepatology where it is identified in nearly half of cirrhosis patients. It is a complex construct consisting of multisystemic physiological decline and increased vulnerability to stressors. Diagnosis is complicated by lack of a consensus definition and measurement tool for frailty in cirrhosis. Frailty heralds a poor prognosis, predicting increased morbidity and mortality both pre‐ and postliver transplant, independent of MELD score. It is thought to be reversible, with promising data supporting prehabilitation and lifestyle intervention programs. In the future, assessment of patients with cirrhosis is likely to incorporate a measure of frailty, however, further research is required.

Laube, Robyn
Wang, Hogan
Park, Laura
Heyman, Joanne K.
Vidot, Helen
Majumdar, Avik
Strasser, Simone I.
McCaughan, Geoffrey W.
Liu, Ken
Last Modified: 04 Jan 2021 04:25

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