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Cirrhosis and frailty assessment in elderly patients: A paradoxical result

机译:老年患者肝硬化和脆弱评估:矛盾的结果

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The frailty represents a key determinant of elderly clinical assessment, especially because it allows the identification of risk factors potentially modifiable by clinical and therapeutic interventions. The frailty assessment in elderly patients usually is made by using of Fried criteria. However, to assess the frailty in cirrhotic patients, multiple but different tools are used by researchers. Thus, we aimed to compare frailty prevalence in elderly patients with well-compensated liver cirrhosis and without cirrhosis , according to Fried criteria. Among 205 elderly patients screened, a total of 148 patients were enrolled. The patients were divided into 2 groups according to the presence/absence of well-compensated liver cirrhosis . After clinical examination with conventional scores of cirrhosis , all patients underwent anthropometric measurements, nutritional, biochemical, comorbidity, and cognitive performances. Frailty assessment was evaluated according to Fried frailty criteria. Unexpectedly, according to the Fried criteria, non-cirrhotic patients were frailer (14.2%) than well-compensated liver cirrhotic patients (7.5%). The most represented Fried criterion was the unintentional weight loss in non-cirrhotic patients (10.1%) compared to well-compensated liver cirrhotic patients (1.4%). Moreover, cumulative illness rating scale -G severity score was significantly and positively associated with frailty status ( r = 0.234, P .004). In a multivariate linear regression model, only female gender, body mass index and mini nutritional assessment resulted associated with frailty status, independently of other confounding variables. Despite the fact that elderly cirrhotic patients are considered to be frailer than the non-cirrhotic elderly patient, relying solely on “mere visual appearance,” our data show that paradoxically non-cirrhotic elderly patients are frailer than elderly well-compensated liver cirrhotic patients. Thus, clinical implication of this finding is that frailty assessment performed in the well-compensated liver cirrhotic patient can identify those cirrhotic patients who may benefit from tailored interventions similarly to non-cirrhotic elderly patients.
机译:脆弱代表了老年临床评估的关键决定因素,特别是因为它允许通过临床和治疗干预识别可能可修改的风险因素。老年患者的脆弱评估通常是通过使用油炸标准进行的。然而,为了评估肝硬化患者的脆弱,研究人员使用多种但不同的工具。因此,根据Fring标准,我们旨在比较老年人患有良好补偿肝硬化患者和没有肝硬化的患者的患者。在筛选的205名老年患者中,共有148名患者注册。根据良好补偿肝硬化的存在/不存在,患者分为2组。在临床检查肝硬化常规评分后,所有患者均接受了人类测量测量,营养,生化,合并症和认知性能。根据油炸的脆弱标准评估脆弱的评估。意外地,根据油炸标准,非肝硬化患者是易于补偿的肝硬化患者(7.5%)。与良好补偿的肝硬化患者(1.4%)相比,最代表性的油炸标准是非肝硬化患者(10.1%)的无意减肥(10.1%)。此外,累积疾病评定量表级-G严重程度与脆弱状态有显着且正相关(r = 0.234,p <.004)。在多变量线性回归模型中,只有女性性别,体重指数和迷你营养评估导致与其他混淆变量无关。尽管老年肝硬化患者被认为是不肝硬化的老年患者,但依靠“仅仅是视觉外观”,我们的数据表明,矛盾的非肝硬化的老年患者是比老年补偿肝硬化患者更加脆弱的患者。因此,这种发现的临床意义是在补偿良好的肝硬化患者中进行的脆弱评估可以识别这些肝硬化患者,这些患者可能与非肝硬化的老年患者类似地受益于量身定制的干预措施。

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