Most Read Articles
Pearl Toh, 3 days ago
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
6 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.
Pearl Toh, 07 Dec 2018
Apixaban slashes the risk of recurrent venous thromboembolism (VTE) by 90 percent in cancer patients compared with the low-molecular-weight heparin (LMWH) dalteparin, with no increase in major bleeding risk, according to the ADAM VTE study presented at ASH 2018.
2 days ago
Rates of major bleeding events are similar across cancer patients taking direct oral anticoagulants (DOAC), low-molecular-weight heparin (LMWH) or vitamin K antagonist (VKA), with gastrointestinal bleeding being the most frequent event, a recent study has shown. In addition, DOAC and LMWH recorded higher rates of venous thromboembolism than earlier studies.

Liver frailty index improves mortality prediction of subjective clinician assessment

18 Mar 2018

Addition of the liver frailty index (LFI) to the subjective clinician assessment significantly improves mortality risk prediction, according to a recent study.

The researchers recruited 529 cirrhosis outpatients (median age 58 years; 42 percent female) who were awaiting liver transplantation. Participants underwent both objective LFI and subjective clinician assessments. Concordance statistics were used to determine the discriminative ability of the methods.

The median LFI score was 3.8 (3.4–4.3), while the median subjective clinician assessment score was 2 (1–3). Eight trained professionals administered the LFI to the participants, and the scores were statistically similar (p=0.28). In both cases, higher scores indicated greater patient frailty.

Spearman’s correlation analysis showed that scores in the LFI and subjective clinician assessments were significantly and positively associated with each other (p<0.001).

A univariable Cox regression analysis showed that each unit increase in the LFI was significantly associated with waitlist mortality (hazard ratio [HR], 2.9; 95 percent CI, 2.2–3.7; p<0.001). The same trend was found with the subjective clinician assessment (HR, 1.9; 1.6–2.3; p<0.001).

Multivariable adjustments did not significantly attenuate relationship of LFI (HR, 2.21; 1.68–2.91; p<0.001) and subjective clinician assessment (HR, 1.59; 1.30–1.94; p<0.001) with waitlist mortality.

Individually, the LFI and subjective clinician assessment had acceptable abilities to correctly rank patients according to their risk of death (C-statistic, 0.71 vs 0.68; p=0.41). The combination of the two significantly improved mortality prediction, resulting in a significantly better C-statistic relative to subjective assessments alone (p<0.02) but not to LFI alone (p=0.31).

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Most Read Articles
Pearl Toh, 3 days ago
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
6 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.
Pearl Toh, 07 Dec 2018
Apixaban slashes the risk of recurrent venous thromboembolism (VTE) by 90 percent in cancer patients compared with the low-molecular-weight heparin (LMWH) dalteparin, with no increase in major bleeding risk, according to the ADAM VTE study presented at ASH 2018.
2 days ago
Rates of major bleeding events are similar across cancer patients taking direct oral anticoagulants (DOAC), low-molecular-weight heparin (LMWH) or vitamin K antagonist (VKA), with gastrointestinal bleeding being the most frequent event, a recent study has shown. In addition, DOAC and LMWH recorded higher rates of venous thromboembolism than earlier studies.