Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates
Avesh J. Thuluvath, Andres Duarte-Rojo, Jennifer C. Lai, John Peipert, Zachary C. Dietch, Osama Siddiqui, Sheila Morrissey, Kimberly Belfanti, Lihui Zhao, Kexin Guo, Mohammad Nizamuddin, Praneet Polineni, Josh Levitsky, Ann-Marie Flores, Daniela P. Ladner- Transplantation
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 (
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.