Tale of the Frail: Understanding Frailty in Cirrhosis

Pradhan, Faruq; Narang, Natasha; Fallon, Michael B.

doi:10.14423/smj.0000000000001224

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…The early and prompt assessment of frailty in cirrhotic patients is crucial for healthcare providers to enhance comprehensive care for ESLD patients[ 142 ]. Frailty has been observed to be a valuable predictor of outcomes both before and following therapeutic interventions.…”

Section: Assessment Of Frailty In Liver Diseasesmentioning

confidence: 99%

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

Elsheikh,

Sabagh,

Mohamed

et al. 2023

World J Gastroenterol

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Frailty and sarcopenia are frequently observed in patients with end-stage liver disease. Frailty is a complex condition that arises from deteriorations across various physiological systems, including the musculoskeletal, cardiovascular, and immune systems, resulting in a reduced ability of the body to withstand stressors. This condition is associated with declined resilience and increased vulnerability to negative outcomes, including disability, hospitalization, and mortality. In cirrhotic patients, frailty is influenced by multiple factors, such as hyperammonemia, hormonal imbalance, malnutrition, ascites, hepatic encephalopathy, and alcohol intake. Assessing frailty is crucial in predicting morbidity and mortality in cirrhotic patients. It can aid in making critical decisions regarding patients’ eligibility for critical care and transplantation. This, in turn, can guide the development of an individualized treatment plan for each patient with cirrhosis, with a focus on prioritizing exercise, proper nutrition, and appropriate treatment of hepatic complications as the primary lines of treatment. In this review, we aim to explore the topic of frailty in liver diseases, with a particular emphasis on pathophysiology, clinical assessment, and discuss strategies for preventing frailty through effective treatment of hepatic complications. Furthermore, we explore novel assessment and management strategies that have emerged in recent years, including the use of wearable technology and telemedicine.

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Section: Assessment Of Frailty In Liver Diseasesmentioning

confidence: 99%

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

Elsheikh,

Sabagh,

Mohamed

et al. 2023

World J Gastroenterol

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Frailty in liver transplantation: Exploring prescribing exercise as medicine to improve patient outcomes

Harris,

Stine

2024

Liver International

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Liver transplantation (LT) represents a curative avenue for individuals with advanced chronic liver disease. Given the inherent illness severity of LT candidates, identifying patients at greater risk for adverse outcomes before and after transplantation is paramount. Approximately 50% of cirrhotic patients are frail and have considerable functional impairment. Various measures have been used to assess frailty, including performance‐based tests and functional status evaluations. Frailty carries significant prognostic implications and predicts both mortality and pre‐ and post‐LT complications. Contributing factors to frailty in this population include sarcopenia, malnutrition, inflammation, and psychosocial factors. Recognizing the prevalence of frailty among LT candidates, exercise interventions have been developed to improve physical frailty and offer potential to improve patient outcomes. While many interventions have demonstrated efficacy without notable adverse events, the absence of a universally accepted standard for exercise prescription underscores the variability in intervention elements and patient adherence. Given the safety profile of exercise interventions, there remains a critical need for standardized protocols and guidelines to optimize exercise regimens for LT candidates. This review delves into the landscape of frailty among LT candidates, elucidating its etiological underpinnings, impact on outcomes, utilization of exercise interventions, and the efficacy of exercise programs in reducing the burden frailty in those awaiting LT.

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Tale of the Frail: Understanding Frailty in Cirrhosis

Cited by 2 publications

References 32 publications

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

Frailty in liver transplantation: Exploring prescribing exercise as medicine to improve patient outcomes

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