Frailty Assessment in Patients with Liver Cirrhosis

Jacobs, Amanda C. Van

doi:10.1002/cld.825

Cited by 20 publications

(26 citation statements)

References 19 publications

(19 reference statements)

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“…Every 100 m decrease in the 6MWD represents an almost 50% increase in waitlist mortality, independent of liver disease severity. 17,18 Intervention…”

Section: Muscle Massmentioning

confidence: 99%

Sarcopenia in cirrhosis: A practical overview

Dhaliwal

Armstrong

2020

Clinical Medicine

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Patients with liver cirrhosis and, in particular, those with liver failure are at high risk of reduced muscle mass and strength/ function, otherwise known as sarcopenia. Sarcopenia is a complex, multifactorial (poor nutritional intake, protein catabolism, physical inactivity) chronic condition, which increases the risk of liver-related morbidity and mortality. Early recognition and tailored management incorporating high protein diets and combination aerobic/resistance exercise can ameliorate the complications associated with sarcopenia in cirrhosis. This review provides an overview of the epidemiology, pathogenesis, assessment tools and management of sarcopenia in cirrhosis.

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“…Every 100 m decrease in the 6MWD represents an almost 50% increase in waitlist mortality, independent of liver disease severity. 17,18 Intervention…”

Section: Muscle Massmentioning

confidence: 99%

Sarcopenia in cirrhosis: A practical overview

Dhaliwal

Armstrong

2020

Clinical Medicine

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“…For one, DEXA provides a highly reliable estimation of muscle mass with minimal radiation exposure (54,55); additionally, DEXA is a cost-effective option as it would provide information regarding muscle mass and bone integrity simultaneously. Assessment of frailty can be performed via different validated tests such as the Clinical Frailty Scale, FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) Scale, and the Timed Get-Up-and-Go Test or testing of qualities such as grip strength, gait speed, chair stands, and ability to perform activities of daily living (56,57). Assessment of HE can be implemented by assessment tools such the West-Haven score and the FOUR Score test, which evaluates eyes, motor response, respiration, and brainstem response (42,43,58).…”

Section: Establish a Patient Profilementioning

confidence: 99%

A narrative review of nutritional abnormalities, complications, and optimization in the cirrhotic patient

Warner¹,

Aloor²

2022

Transl Gastroenterol Hepatol

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Objective: The purpose of this manuscript is to identify the pathophysiology of the metabolic abnormalities observed in cirrhosis and to uncover associations, if any, to its complications, such as sarcopenia and hepatic encephalopathy (HE).Background: Liver dysfunction in cirrhosis is known to be a precipitating factor in the disruption of many physiological pathways, specifically nutrient metabolism. As a result, affected patients are highly susceptible to derangements of processes affecting multiple classes of macro-and micronutrients, including proteins, carbohydrates, electrolytes, vitamins, and minerals. These disruptions are thought to be contributory to the pathogenesis of known complications of cirrhosis.Methods: Literature research of relevant topics was conducted for the above stated objective; sources were limited to articles from peer-reviewed journals published within the last 30 years.Conclusions: This research established that there is positive correlation between nutrient derangements and the increased risk of complications of cirrhosis, which themselves carry significant morbidity and mortality risk. It also established that some nutrient and electrolyte abnormalities are independent indicators of prognosis and adverse outcomes, such as mortality. This also highlights the importance of comprehension of anomalous metabolism and its complications as it necessitates serious consideration in clinical care. In addition to medical management, cirrhotic patients also require ancillary assessment, such as comprehensive nutritional evaluation, to identify and treat reversible nutritional derangements. This consideration provides the best opportunity to achieve maximal health outcomes in the cirrhotic patient population.

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“…Frailty may be present in up to half of patients awaiting LT 3 . Although the mechanism of frailty in liver disease is complex, it may result from an impairment across multiple organ systems, including neuromuscular, endocrine, skeletal muscle, immune, and gut microbiome.…”

Section: Frailtymentioning

confidence: 99%