Frailty in liver cirrhosis ‒ insights into prevalence, determinants, and clinical impact from a tertiary center experience

Abstract

Introduction and aim. Frailty has emerged as a critical determinant of poor outcomes in patients with liver cirrhosis. This study aims to determine the prevalence and predictors of frailty in patients with liver cirrhosis and assess its clinical impact on disease severity. Material and methods. This cross-sectional study included 460 patients with liver cirrhosis were classified into frail Clinical Frailty Scale (CFS) >4 and non-frail (CFS≤4) groups. Results. The prevalence of frailty among the studied patients was 45.7%. Frail patients were significantly older (60.61±9.06 years), without gender predilection (43.7%, 47.9%). Patients with frailty exhibited significantly worse liver function; higher bilirubin (1.30 (0.90–2.0) vs 0.90 (0.66–1.30) mg/dL, p<0.001) and low albumin (3.9 (3.50–4.10) vs 3.2 (2.60–3.70) g/dL, p<0.001). Multivariate analysis identified age (OR=1.055, 95%CI: 1.023–1.088, p<0.001), body mass index (OR=9.803, 95%CI: 5.067–18.963, p<0.001), and high nutritional risk (OR=20.186, 95%CI: 8.456–48.191, p<0.001) as independent predictors of frailty. Conclusion. Frailty is a significant concern in patients with liver cirrhosis, particularly those with advanced age, diabetes, and severe hepatic dysfunction. Optimizing outcomes for this patient population requires a multi-faceted approach that considers liver disease management, routine frailty assessment, and interventions to enhance physical resilience and address co-morbidities.