What question did this study set out to answer?

Determine whether frailty, an indicator of physiologic vulnerability, predicts mortality or delisting among candidates awaiting liver transplantation.

June 16, 2014American Journal of TransplantationOpen Access

Frailty Predicts Waitlist Mortality in Liver Transplant Candidates

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Authors

JLJennifer C. LaiUniversity of California, San Francisco SFSandy FengUniversity of California, San Francisco NTN.A. TerraultUniversity of Modena and Reggio Emilia

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Implication

Cohort study reveals increased waitlist mortality among frail liver transplant candidates, indicating frailty predicts survival independent of liver disease severity.

Key Points

Determine whether frailty, an indicator of physiologic vulnerability, predicts mortality or delisting among candidates awaiting liver transplantation.
Prospective cohort study of 294 consecutive adult liver transplant candidates with MELD ≥ 12 (median age 60, median MELD 15) followed for 12 months at a single center (97% recruitment rate).
Assessed frailty using the Fried Frailty scale, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL), and Instrumental ADL (IADL) scales.
Used competing risks models to examine the association between frailty metrics and waitlist mortality (death or delisting for being too sick) adjusted for MELD score.
Seventeen percent of candidates met criteria for frailty (Fried Frailty score ≥ 3), exhibiting significantly higher 12-month waitlist mortality or delisting than non-frail candidates (22% [11/51] vs. 10% [25/243], p = 0.03).
Each 1-unit increase in the Fried Frailty score was associated with a 45% increased risk of waitlist mortality after adjusting for MELD (95% CI, 4-202).
Each 1-unit decrease in the Short Physical Performance Battery score was independently associated with higher waitlist mortality (HR 1.19, 95% CI 1.07-1.32).

Cite This Study

Lai et al. (2014) studied this question.

synapsesocial.com/papers/6a7cb7014ec837fd6928a95d https://doi.org/10.1111/ajt.12762

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Implication

Cohort study reveals increased waitlist mortality among frail liver transplant candidates, indicating frailty predicts survival independent of liver disease severity.

Frailty Predicts Waitlist Mortality in Liver Transplant Candidates

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Cite This Study

Frailty Predicts Waitlist Mortality in Liver Transplant Candidates

Discussion

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Implication

Key Points

Cite This Study

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