Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up

Introduction and objectives: Frailty is characterized by a poor restoration of homeostasis after a stressor event. Although it is not usually diagnosed, it has been associated with decreased survival in cirrhotic patients. We aimed to evaluate the impact of frailty and decreased gait speed over surv...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Rubén Soto, Luis Antonio Díaz, Violeta Rivas, Eduardo Fuentes-López, Macarena Zalaquett, María José Bruera, Cecilia González, Gabriel Mezzano, Carlos Benítez
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Frailty Sarcopenia Cirrhosis Liver transplantation Mortality Survival Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/b9e48b3f8cbe48f7b534fcfa7648ef48
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b9e48b3f8cbe48f7b534fcfa7648ef48
record_format	dspace
spelling	oai:doaj.org-article:b9e48b3f8cbe48f7b534fcfa7648ef482021-11-18T04:45:59ZFrailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up1665-268110.1016/j.aohep.2021.100327https://doaj.org/article/b9e48b3f8cbe48f7b534fcfa7648ef482021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1665268121000260https://doaj.org/toc/1665-2681Introduction and objectives: Frailty is characterized by a poor restoration of homeostasis after a stressor event. Although it is not usually diagnosed, it has been associated with decreased survival in cirrhotic patients. We aimed to evaluate the impact of frailty and decreased gait speed over survival in cirrhotic patients at long-term follow-up. Materials and methods: We included stable cirrhotic patients Child–Pugh B-C or MELD ≥12, ≥50 years old. We performed a clinical evaluation, anthropometry, and laboratory tests. Frailty was diagnosed using Fried Frailty Index. We evaluated survival at a 4-year follow-up. Results: We included 126 patients; mean age 64 ± 8.3 years, median MELD-Na 15[12–17], median follow-up was 881 [349–1277] days. The main etiology was MAFLD (31.4%). Frailty was diagnosed in 65.1% of patients. There were no significant differences in baseline characteristics per frailty condition. Mortality was higher in frail patients than non-frail patients (68.2% versus 20.6% at 48 months, respectively; p-value <0.001). The mean gait speed in frail and non-frail patients was 0.86 ± 0.3 m/s and 1.16 ± 0.2 m/s, respectively (p-value <0.001). Interestingly, 26.9% of patients presented a reduced gait speed (≤0.8 m/s). Patients with decreased gait speed also had higher mortality than patients with normal gait speed (79.9% versus 40.8%, respectively; p-value <0.001). A multivariate-adjusted model showed that decreased gait speed (HR = 3.27, 95%CI:1.74–6.14; p < 0.001) and frailty (HR = 4.24, 95%CI:1.89–9.51; p < 0.001) were associated with mortality. Conclusions: Frailty is independently associated with decreased survival at long-term follow-up. Reduced gait speed is strongly associated with mortality and could be a surrogate marker of frailty in clinical practice.Rubén SotoLuis Antonio DíazVioleta RivasEduardo Fuentes-LópezMacarena ZalaquettMaría José BrueraCecilia GonzálezGabriel MezzanoCarlos BenítezElsevierarticleFrailtySarcopeniaCirrhosisLiver transplantationMortalitySurvivalSpecialties of internal medicineRC581-951ENAnnals of Hepatology, Vol 25, Iss , Pp 100327- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Frailty Sarcopenia Cirrhosis Liver transplantation Mortality Survival Specialties of internal medicine RC581-951
spellingShingle	Frailty Sarcopenia Cirrhosis Liver transplantation Mortality Survival Specialties of internal medicine RC581-951 Rubén Soto Luis Antonio Díaz Violeta Rivas Eduardo Fuentes-López Macarena Zalaquett María José Bruera Cecilia González Gabriel Mezzano Carlos Benítez Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
description	Introduction and objectives: Frailty is characterized by a poor restoration of homeostasis after a stressor event. Although it is not usually diagnosed, it has been associated with decreased survival in cirrhotic patients. We aimed to evaluate the impact of frailty and decreased gait speed over survival in cirrhotic patients at long-term follow-up. Materials and methods: We included stable cirrhotic patients Child–Pugh B-C or MELD ≥12, ≥50 years old. We performed a clinical evaluation, anthropometry, and laboratory tests. Frailty was diagnosed using Fried Frailty Index. We evaluated survival at a 4-year follow-up. Results: We included 126 patients; mean age 64 ± 8.3 years, median MELD-Na 15[12–17], median follow-up was 881 [349–1277] days. The main etiology was MAFLD (31.4%). Frailty was diagnosed in 65.1% of patients. There were no significant differences in baseline characteristics per frailty condition. Mortality was higher in frail patients than non-frail patients (68.2% versus 20.6% at 48 months, respectively; p-value <0.001). The mean gait speed in frail and non-frail patients was 0.86 ± 0.3 m/s and 1.16 ± 0.2 m/s, respectively (p-value <0.001). Interestingly, 26.9% of patients presented a reduced gait speed (≤0.8 m/s). Patients with decreased gait speed also had higher mortality than patients with normal gait speed (79.9% versus 40.8%, respectively; p-value <0.001). A multivariate-adjusted model showed that decreased gait speed (HR = 3.27, 95%CI:1.74–6.14; p < 0.001) and frailty (HR = 4.24, 95%CI:1.89–9.51; p < 0.001) were associated with mortality. Conclusions: Frailty is independently associated with decreased survival at long-term follow-up. Reduced gait speed is strongly associated with mortality and could be a surrogate marker of frailty in clinical practice.
format	article
author	Rubén Soto Luis Antonio Díaz Violeta Rivas Eduardo Fuentes-López Macarena Zalaquett María José Bruera Cecilia González Gabriel Mezzano Carlos Benítez
author_facet	Rubén Soto Luis Antonio Díaz Violeta Rivas Eduardo Fuentes-López Macarena Zalaquett María José Bruera Cecilia González Gabriel Mezzano Carlos Benítez
author_sort	Rubén Soto
title	Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
title_short	Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
title_full	Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
title_fullStr	Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
title_full_unstemmed	Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
title_sort	frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/b9e48b3f8cbe48f7b534fcfa7648ef48
work_keys_str_mv	AT rubensoto frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT luisantoniodiaz frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT violetarivas frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT eduardofuenteslopez frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT macarenazalaquett frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT mariajosebruera frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT ceciliagonzalez frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT gabrielmezzano frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup AT carlosbenitez frailtyandreducedgaitspeedareindependentlyrelatedtomortalityofcirrhoticpatientsinlongtermfollowup
_version_	1718425062672957440

Frailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up

Ejemplares similares