Most Read Articles
Stephen Padilla, 4 days ago
Diabetic patients in a decompensated state and who develop type 2 myocardial infarction (MI) have an increased risk for mortality and major adverse cardiac events (MACE), according to a new study. In addition, these patients are potentially at risk for undiagnosed coronary artery disease.
6 days ago
Chocolate consumption is not associated with risk of coronary heart disease (CHD), stroke or both combined in postmenopausal women free of pre-existing major chronic disease, a study suggests.
Pearl Toh, 13 Jul 2018
More intensive lowering of LDL-C levels was associated with a progressively greater survival benefit than less intensive approach, when the baseline LDL-C levels were ≥100 mg/dL, reveals a meta-analysis of 34 randomized trials.
6 days ago
Switching from thiazide diuretic to ipragliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, leads to improvements in metabolic parameters and body mass composition without affecting blood pressure in type 2 diabetes (T2D) patients, a recent study has found.

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
Stephen Padilla, 4 days ago
Diabetic patients in a decompensated state and who develop type 2 myocardial infarction (MI) have an increased risk for mortality and major adverse cardiac events (MACE), according to a new study. In addition, these patients are potentially at risk for undiagnosed coronary artery disease.
6 days ago
Chocolate consumption is not associated with risk of coronary heart disease (CHD), stroke or both combined in postmenopausal women free of pre-existing major chronic disease, a study suggests.
Pearl Toh, 13 Jul 2018
More intensive lowering of LDL-C levels was associated with a progressively greater survival benefit than less intensive approach, when the baseline LDL-C levels were ≥100 mg/dL, reveals a meta-analysis of 34 randomized trials.
6 days ago
Switching from thiazide diuretic to ipragliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, leads to improvements in metabolic parameters and body mass composition without affecting blood pressure in type 2 diabetes (T2D) patients, a recent study has found.