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. 2018 Oct 25;7(11):386.
doi: 10.3390/jcm7110386.

Low Blood ALT Activity and High FRAIL Questionnaire Scores Correlate with Increased Mortality and with Each Other. A Prospective Study in the Internal Medicine Department

Gringauz Irina  1 , Cohen Refaela  2 , Brom Adi  3 , Davidi Avia  4 , Hofstetter Liron  5 , Avaki Chen  6 , Segal Gad  7
Affiliations

Low Blood ALT Activity and High FRAIL Questionnaire Scores Correlate with Increased Mortality and with Each Other. A Prospective Study in the Internal Medicine Department

Gringauz Irina et al. J Clin Med. .

Abstract

Background: Low blood ALT, Alanine aminotransferase activity and high FRAIL (Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight) questionnaire scores were previously shown to be associated with frailty and increased risk of mortality. We aimed to correlate these tools with mortality and each other in patients hospitalized in an internal medicine department.

Methods: This is a prospective study in a large tertiary hospital. We assessed the predictive value for clinical outcomes of both low ALT blood activity and the pre-frail and frail categories of the "FRAIL" questionnaire.

Results: During a 15 months study, 179 consecutive patients were recruited, of whom 20 died. When all study participants were divided to three groups according to admission ALT levels (below 10 IU/L, 11 to 19 IU/L and above 20 IU/L) we found a statistically significant difference in the rate of mortality: 4 patients died within the group of ALT < 10 IU/L, 14 patients died in the group of 10 IU/L < ALT < 19 IU/L and in the group of patients with ALT > 20 IU/L, only 2 patients died (p = 0.042). A higher score on the FRAIL questionnaire was associated, with statistical significance, with higher risk of mortality (p = 0.029). There was a significant correlation (p = 0.038) between blood ALT activity and the pre-frailty and frailty classifications by the FRAIL Questionnaire.

Conclusions: Both the FRAIL questionnaire and blood ALT activity are simple and practical tools for frailty assessment and risk stratification of patients hospitalized in the internal medicine department. Both tool's results also correlate with each other.

Keywords: ALT; FRAIL questionnaire; frailty; internal medicine; sarcopenia; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curve according to ALT, Alanine Aminotransferase levels on admission: below and over 20 IU/L.
Figure 2
Figure 2
Kaplan-Meier survival curve according to ALT groups on admission: below 10 IU/L, between 10 to 19 IU/L and over 20 IU/L.
Figure 3
Figure 3
Kaplan-Meier survival curve according to FRAIL Questionnaire.
Figure 4
Figure 4
Low ALT values correlate with FRAIL Questionnaire groups.
See this image and copyright information in PMC

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