A prospective analysis of factors associated with decreased physical activity in patients with cirrhosis undergoing transplant evaluation

Abstract

Background Physical activity has been associated with improved recovery time after transplantation. Handgrip strength has been related to post-transplant outcomes. Aim To evaluate predictors of physical activity and grip strength in cirrhotic patients undergoing liver transplant evaluation. Methods Single center, prospective analysis. Results A hundred patients were evaluated (54% male, mean age 53 ± 9). Common etiologies of liver disease were non-alcoholic hepatitis (27%), hepatitis C (22%), and alcoholic liver disease (21%). Mean MELD score was 13.5. Forty one percent had a history of smoking. Ninety-three patients completed the International Physical Activity Questionnaire. The median total physical activity score of 33 MET-min/weeks. The mean total grip strength was 62.1 ± 22lb. Total grip strength was found to be an independent predictor of low-moderate physical activity (OR 4.7, 95% CI 1.4–16.2, p=0.038) and smoking was the only significant factor associated with reduced grip strength (OR 3.4, 95% CI 1.4–8, p=0.005). Conclusions End-Stage Liver Disease patients undergoing liver transplant evaluation have reduced total physical activity by IPAQ. Total Grip Strength was found to be a significant predictor of low-moderate physical activity in patients with cirrhosis. Smoking is a risk factor for reduced grip strength, an important indicator of muscle wasting in cirrhotics.

Striking the Right Note: Assessing the Recipient for Liver Transplantation in Low- and Middle-Income Countries

“…Multiple factors are responsible for this malnutrition and associated sarcopenia. 12 There are different methods for evaluation of nutritional status like body mass index (BMI) and subjective global assessment (SGA). Anthropometric measurements, bioelectrical impedance analysis, and dual energy x-ray absorptiometry are used to assess the degree of sarcopenia.…”

“…14 It is interesting to note that no correlation was found between grip strength and hepatorenal syndrome, variceal bleeding, and spontaneous bacterial peritonitis, but age and smoking were associated with reduced grip strength in cirrhotic patients. 12 …”