Patient-Reported Physical Function Correlates with Liver Frailty Index and 4-Meter Gait Speed in Patients with Cirrhosis
Northwestern University Feinberg School of Medicine, Chicago, IL
Meeting: 2022 American Transplant Congress
Abstract number: 126
Keywords: Liver, Liver cirrhosis, Liver transplantation, Quality of life
Topic: Clinical Science » Liver » 53 - Liver: Cirrhosis - Portal Hypertension and Other Complications
Session Information
Session Name: Cirrhosis: Complications, Portal Hypertension and Renal Management
Session Type: Rapid Fire Oral Abstract
Date: Sunday, June 5, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 6:10pm-6:20pm
Location: Hynes Room 311
*Purpose: Frailty is highly prevalent in patients with end-stage liver disease and strongly predicts waitlist and post-transplant mortality. The Liver Frailty Index (LFI) and 4-meter gait speed (4MGS) are validated measures of frailty in cirrhosis, but their association with patient-reported physical function has never been studied. Thus, we tested the correlation of patient-reported physical function with LFI and 4MGS in patients with cirrhosis.
*Methods: In a single-center prospective study, adult patients with cirrhosis undergoing liver transplant (LT) evaluation were enrolled starting in 10/2020. LFI (robust: LFI <3.2, pre-frail: LFI 3.2-4.4, frail: ≥ 4.5) and 4MGS (seconds required to walk 4 meters) were measured. Patients also assessed their own physical function using the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (short form 8c) questionnaire, a validated measure of physical and functional quality of life that uses T-scores normed to the general population. Demographics, etiology and complications of liver disease, labs and MELD-Na scores were obtained from the electronic medical record.
*Results: 76 LT candidates were enrolled between 10/2020-11/2021. The mean age was 57.6 (±9.7) yrs, 45 (59%) were male, 82% White, 10% Black, 4% Hispanic, 4% Asian and the mean BMI was 28.9 (±5.9). Cirrhosis etiologies were ETOH (30%), HCV (20%), NASH (20%), PBC (12%), AIH (9%) and Other (9%). The mean MELD-Na was 17.5 (±6.3) and 72% had decompensated cirrhosis. The mean LFI was 3.69 (±0.78), mean 4MGS was 3.8 (±1.2) seconds and the mean PROMIS physical function T-score was 44.9 (±8.4). PROMIS physical function T-scores significantly correlated with LFI scores (r = -0.54, p < 0.001) and 4MGS (r = -0.48, p < 0.001).
*Conclusions: Patient-reported physical function assessed by PROMIS significantly correlates with LFI and 4MGS in patients with cirrhosis evaluated for LT. In the future, PROMIS physical function surveys may be used to assess frailty instead of in-person assessments and guide interventions in patients awaiting LT.
To cite this abstract in AMA style:
Thuluvath AJ, Peipert J, Belfanti K, Morrissey S, Siddiqui O, Levitsky J, Dietch Z, Flores A, Ladner DP. Patient-Reported Physical Function Correlates with Liver Frailty Index and 4-Meter Gait Speed in Patients with Cirrhosis [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-reported-physical-function-correlates-with-liver-frailty-index-and-4-meter-gait-speed-in-patients-with-cirrhosis/. Accessed May 16, 2025.« Back to 2022 American Transplant Congress