Frailty in advanced liver disease
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 th...
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| Veröffentlicht in: | Liver international 2018-12, Vol.38 (12), p.2117-2128 |
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| container_title | Liver international |
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| creator | Laube, Robyn Wang, Hogan Park, Laura Heyman, Joanne K. Vidot, Helen Majumdar, Avik Strasser, Simone I. McCaughan, Geoffrey W. Liu, Ken |
| description | 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. |
| doi_str_mv | 10.1111/liv.13917 |
| format | Article |
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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.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.13917</identifier><identifier>PMID: 29935102</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Activities of Daily Living ; Cirrhosis ; End Stage Liver Disease - diagnosis ; End Stage Liver Disease - mortality ; End Stage Liver Disease - surgery ; Exercise ; Frailty ; Frailty - etiology ; Frailty - rehabilitation ; Humans ; Liver ; Liver cirrhosis ; Liver Cirrhosis - complications ; Liver Cirrhosis - surgery ; Liver diseases ; Liver Transplantation ; Morbidity ; nutrition ; Nutritional Status ; Patients ; Physiology ; Predictive Value of Tests ; prognostication ; Randomized Controlled Trials as Topic ; sarcopenia ; Sarcopenia - etiology ; Sarcopenia - rehabilitation ; Severity of Illness Index</subject><ispartof>Liver international, 2018-12, Vol.38 (12), p.2117-2128</ispartof><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2018 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4547-ef50b7fd6dc3ceba838b24f3c42b648f78d9060d130dd346823d498d9f48400d3</citedby><cites>FETCH-LOGICAL-c4547-ef50b7fd6dc3ceba838b24f3c42b648f78d9060d130dd346823d498d9f48400d3</cites><orcidid>0000-0002-0453-3168</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.13917$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.13917$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29935102$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Laube, Robyn</creatorcontrib><creatorcontrib>Wang, Hogan</creatorcontrib><creatorcontrib>Park, Laura</creatorcontrib><creatorcontrib>Heyman, Joanne K.</creatorcontrib><creatorcontrib>Vidot, Helen</creatorcontrib><creatorcontrib>Majumdar, Avik</creatorcontrib><creatorcontrib>Strasser, Simone I.</creatorcontrib><creatorcontrib>McCaughan, Geoffrey W.</creatorcontrib><creatorcontrib>Liu, Ken</creatorcontrib><title>Frailty in advanced liver disease</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>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.</description><subject>Activities of Daily Living</subject><subject>Cirrhosis</subject><subject>End Stage Liver Disease - diagnosis</subject><subject>End Stage Liver Disease - mortality</subject><subject>End Stage Liver Disease - surgery</subject><subject>Exercise</subject><subject>Frailty</subject><subject>Frailty - etiology</subject><subject>Frailty - rehabilitation</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Cirrhosis - surgery</subject><subject>Liver diseases</subject><subject>Liver Transplantation</subject><subject>Morbidity</subject><subject>nutrition</subject><subject>Nutritional Status</subject><subject>Patients</subject><subject>Physiology</subject><subject>Predictive Value of Tests</subject><subject>prognostication</subject><subject>Randomized Controlled Trials as Topic</subject><subject>sarcopenia</subject><subject>Sarcopenia - etiology</subject><subject>Sarcopenia - rehabilitation</subject><subject>Severity of Illness Index</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFKAzEQhoMotlYPvoCseNHDtkkmu5scS7FaKHhRryG7SSBlu1uTbqVvb3RrD4JzmWH4-Jj5EbomeExiTWq3GxMQpDhBQ8IKngIFcnqcKQzQRQgrjIkQGTlHAyoEZATTIbqde-Xq7T5xTaL0TjWV0Un0GZ9oF4wK5hKdWVUHc3XoI_Q2f3ydPafLl6fFbLpMK5axIjU2w2Vhda4rqEypOPCSMgsVo2XOuC24FjjHmgDWGljOKWgm4tIyzjDWMEL3vXfj24_OhK1cu1CZulaNabsgKc54hglmIqJ3f9BV2_kmXicpAR7fBA6ReuipyrcheGPlxru18ntJsPzOTcY_5U9ukb05GLtybfSR_A0qApMe-HS12f9vksvFe6_8AthXdAY</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Laube, Robyn</creator><creator>Wang, Hogan</creator><creator>Park, Laura</creator><creator>Heyman, Joanne K.</creator><creator>Vidot, Helen</creator><creator>Majumdar, Avik</creator><creator>Strasser, Simone I.</creator><creator>McCaughan, Geoffrey W.</creator><creator>Liu, Ken</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0453-3168</orcidid></search><sort><creationdate>201812</creationdate><title>Frailty in advanced liver disease</title><author>Laube, Robyn ; Wang, Hogan ; Park, Laura ; Heyman, Joanne K. ; Vidot, Helen ; Majumdar, Avik ; Strasser, Simone I. ; McCaughan, Geoffrey W. ; Liu, Ken</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4547-ef50b7fd6dc3ceba838b24f3c42b648f78d9060d130dd346823d498d9f48400d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Activities of Daily Living</topic><topic>Cirrhosis</topic><topic>End Stage Liver Disease - diagnosis</topic><topic>End Stage Liver Disease - mortality</topic><topic>End Stage Liver Disease - surgery</topic><topic>Exercise</topic><topic>Frailty</topic><topic>Frailty - etiology</topic><topic>Frailty - rehabilitation</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver Cirrhosis - surgery</topic><topic>Liver diseases</topic><topic>Liver Transplantation</topic><topic>Morbidity</topic><topic>nutrition</topic><topic>Nutritional Status</topic><topic>Patients</topic><topic>Physiology</topic><topic>Predictive Value of Tests</topic><topic>prognostication</topic><topic>Randomized Controlled Trials as Topic</topic><topic>sarcopenia</topic><topic>Sarcopenia - etiology</topic><topic>Sarcopenia - rehabilitation</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laube, Robyn</creatorcontrib><creatorcontrib>Wang, Hogan</creatorcontrib><creatorcontrib>Park, Laura</creatorcontrib><creatorcontrib>Heyman, Joanne K.</creatorcontrib><creatorcontrib>Vidot, Helen</creatorcontrib><creatorcontrib>Majumdar, Avik</creatorcontrib><creatorcontrib>Strasser, Simone I.</creatorcontrib><creatorcontrib>McCaughan, Geoffrey W.</creatorcontrib><creatorcontrib>Liu, Ken</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Laube, Robyn</au><au>Wang, Hogan</au><au>Park, Laura</au><au>Heyman, Joanne K.</au><au>Vidot, Helen</au><au>Majumdar, Avik</au><au>Strasser, Simone I.</au><au>McCaughan, Geoffrey W.</au><au>Liu, Ken</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frailty in advanced liver disease</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2018-12</date><risdate>2018</risdate><volume>38</volume><issue>12</issue><spage>2117</spage><epage>2128</epage><pages>2117-2128</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>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. 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| subjects | Activities of Daily Living Cirrhosis End Stage Liver Disease - diagnosis End Stage Liver Disease - mortality End Stage Liver Disease - surgery Exercise Frailty Frailty - etiology Frailty - rehabilitation Humans Liver Liver cirrhosis Liver Cirrhosis - complications Liver Cirrhosis - surgery Liver diseases Liver Transplantation Morbidity nutrition Nutritional Status Patients Physiology Predictive Value of Tests prognostication Randomized Controlled Trials as Topic sarcopenia Sarcopenia - etiology Sarcopenia - rehabilitation Severity of Illness Index |
| title | Frailty in advanced liver disease |
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