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. 2024 Feb 1;108(2):491-497.
doi: 10.1097/TP.0000000000004741. Epub 2023 Jul 27.

Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates

Avesh J Thuluvath  1   2 , Andres Duarte-Rojo  3 , Jennifer C Lai  4 , John Peipert  1   5 , Zachary C Dietch  1   6 , Osama Siddiqui  1 , Sheila Morrissey  1   7 , Kimberly Belfanti  1   7 , Lihui Zhao  8 , Kexin Guo  8 , Mohammad Nizamuddin  1 , Praneet Polineni  1 , Josh Levitsky  1   2 , Ann-Marie Flores  1   5   7   9 , Daniela P Ladner  1   5   6
Affiliations

Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates

Avesh J Thuluvath et al. Transplantation. .

Abstract

Background: Frailty is prevalent in patients with end-stage liver disease and predicts waitlist mortality, posttransplant mortality, and frequency of hospitalizations. The Liver Frailty Index (LFI) is a validated measure of frailty in liver transplant (LT) candidates but requires an in-person assessment.

Methods: We studied the association between patient-reported physical function and LFI in a single-center prospective study of adult patients with cirrhosis undergoing LT evaluation from October 2020 to December 2021. Frailty was assessed with the LFI and 4-m gait speed. Patient-reported physical function was evaluated using a brief Patient-Reported Outcomes Measurement Information System (PROMIS) survey.

Results: Eighty-one LT candidates were enrolled, with a mean model of end-stage liver disease-sodium of 17.6 (±6.3). The mean LFI was 3.7 (±0.77; 15% frail and 59% prefrail) and the mean PROMIS Physical Function score was 45 (±8.6). PROMIS Physical Function correlated with LFI ( r = -0.54, P < 0.001) and 4-m gait speed ( r = 0.48, P < 0.001). The mean hospitalization rate was 1.1 d admitted per month. After adjusting for age, sex, and model of end-stage liver disease-sodium, patient-reported physical function-predicted hospitalization rate ( P = 0.001).

Conclusions: This study suggests that a brief patient-reported outcome measure can be used to screen for frailty and predict hospitalizations in patients with cirrhosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Correlation between Liver Frailty Index and PROMIS Physical Function T-score. PROMIS, Patient-Reported Outcomes Measurement System.
Figure 2.
Figure 2.
Correlation between 4-Meter Gait Speed and PROMIS Physical Function T-score. PROMIS, Patient-Reported Outcomes Measurement System.
See this image and copyright information in PMC

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