HealthDay News — A frailty assessment as part of liver transplant evaluation may help identify transplant candidates at higher risk for death, according to a study published in JAMA Surgery.
Christine E. Haugen, MD, PhD, from Johns Hopkins University School of Medicine in Baltimore, and colleagues used data from 1108 liver transplant candidates at 9 US transplant centers (March 1, 2012, to May 1, 2018; mean age, 55 years) to evaluate differences in the association between liver transplant wait-list mortality and frailty by body mass index (BMI). The Liver Frailty Index score was calculated based on grip strength, chair stands, and balance, with frailty defined as a Liver Frailty Index score of ≥4.5.
The researchers found that 26.2% of the candidates were frail, including 25.4% of the 670 nonobese candidates, 26% of 246 candidates with class 1 obesity, and 29.2% of the 192 candidates with at least class 2 obesity (P = 0.57). There was a higher risk for wait-list mortality among frail nonobese candidates and frail candidates with class 1 obesity versus their nonfrail counterparts (nonobese candidates: adjusted subhazard ratio [sHR], 1.54; 95% confidence interval [CI], 1.02 to 2.33; P = 0.04; candidates with class 1 obesity: adjusted sHR, 1.72; 95% CI, 0.99 to 2.99; P = 0.06; P = 0.75 for interaction). There was a 3.19-fold higher adjusted risk for wait-list mortality among frail candidates with at least class 2 obesity versus nonfrail candidates with at least class 2 obesity (95% CI, 1.75 to 5.82; P < 0.001; P = 0.047 for interaction).
“Frailty assessments may help to identify vulnerable patients, particularly those with a BMI of 35.0 or more, in whom a clinician’s visual evaluation may be less reliable to assess muscle mass and nutritional status,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.