Hospital Frailty Risk Score Is Independently Associated with Mortality and Encephalopathy in Hospitalized Patients with Hepatocellular Carcinoma

Biomedicines

Anjali Kewalramani¹  Khoi P. Dang-Ho²  Praneeth Bandaru³  Daryl Ramai⁴  Simonetta Papa⁵  Francesca Cappellini⁵  Fabio Perversi⁵  Luca Giacomelli⁵  Aashni Shah⁵  Sara di Nunzio⁵  Rodolfo Sacco⁶  Antonio Facciorusso⁶ 

[1] Department of Internal Medicine, Mathers Hospital, Port Jefferson, NY 11777, USA;Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA;Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA;Division of Gastroenterology and Hepatology, University of Utah, Salt Lake City, UT 84113, USA;Polistudium SRL, 20135 Milan, Italy;Section of Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;

关键词: hepatocellular carcinoma;    frailty;    outcomes;   

DOI  :  10.3390/biomedicines9111693

来源: DOAJ

【 摘 要 】

Frailty represents a state of vulnerability to multiple internal physiologic factors, as well as external pressures, and has been associated with clinical outcomes. We aim to understand the impact of frailty on patients admitted with hepatocellular carcinoma (HCC) by using the validated Hospital Frailty Risk Score, which is implemented in several hospitals worldwide. We conducted a nation-wide retrospective cohort study to determine the effect of frailty on the risk of in-patient mortality, hepatic encephalopathy, length of stay and cost. Frailty was associated with a 4.5-fold increased risk of mortality and a 2.3-fold increased risk of hepatic encephalopathy. Adjusted Cox regression showed that frailty was correlated with increased risk of in-patient mortality (hazard ratio: 2.3, 95% CI 1.9–2.8, p < 0.001). Frail HCC patients had longer hospital stay (median 5 days) vs. non-frail HCC patients (median 3 days). Additionally, frail patients had higher total costs of hospitalization ($40,875) compared with non-frail patients ($31,667). Frailty is an independent predictor of hepatic encephalopathy and in-patient mortality. Frailty is a surrogate marker of hospital length of stay and cost.

【 授权许可】

Unknown