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

doi:10.1097/TP.0000000000004741

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

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 (r = -0.54, P < 0.001) and 4-m gait speed (r = 0.48, P < 0.001). The mean hospitalization rate was 1.1 d admitted per month. After adjusting for age, sex, and model of end-stage liver disease-sodium, patient-reported physical function-predicted hospitalization rate (P = 0.001). 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.

Original language	English (US)
Pages (from-to)	491-497
Number of pages	7
Journal	Transplantation
Volume	108
Issue number	2
DOIs	https://doi.org/10.1097/TP.0000000000004741
State	Published - Feb 1 2024

Funding

This work was supported by the National Institutes of Health T32DK077662 (A.J.T.), R01AG059183 (J.C.L.), and P30DK026743 (J.C.L.), Digestive Health Foundation Grant (A.J.T., D.P.L.), and the Abecassis Endowment Award (D.P.L.).

ASJC Scopus subject areas

Transplantation

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10.1097/TP.0000000000004741

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Thuluvath, A. J., Duarte-Rojo, A., Lai, J. C., Peipert, J., Dietch, Z. C., Siddiqui, O., Morrissey, S., Belfanti, K., Zhao, L., Guo, K., Nizamuddin, M., Polineni, P., Levitsky, J., Flores, A. M., & Ladner, D. P. (2024). Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates. Transplantation, 108(2), 491-497. https://doi.org/10.1097/TP.0000000000004741

@article{892c7224d307405b956964291a20253d,

title = "Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates",

abstract = "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 (r = -0.54, P < 0.001) and 4-m gait speed (r = 0.48, P < 0.001). The mean hospitalization rate was 1.1 d admitted per month. After adjusting for age, sex, and model of end-stage liver disease-sodium, patient-reported physical function-predicted hospitalization rate (P = 0.001). 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.",

author = "Thuluvath, {Avesh J.} and Andres Duarte-Rojo and Lai, {Jennifer C.} and John Peipert and Dietch, {Zachary C.} and Osama Siddiqui and Sheila Morrissey and Kimberly Belfanti and Lihui Zhao and Kexin Guo and Mohammad Nizamuddin and Praneet Polineni and Josh Levitsky and Flores, {Ann Marie} and Ladner, {Daniela P.}",

year = "2024",

month = feb,

day = "1",

doi = "10.1097/TP.0000000000004741",

language = "English (US)",

volume = "108",

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Thuluvath, AJ, Duarte-Rojo, A, Lai, JC, Peipert, J, Dietch, ZC, Siddiqui, O, Morrissey, S, Belfanti, K, Zhao, L, Guo, K, Nizamuddin, M, Polineni, P, Levitsky, J, Flores, AM & Ladner, DP 2024, 'Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates', Transplantation, vol. 108, no. 2, pp. 491-497. https://doi.org/10.1097/TP.0000000000004741

TY - JOUR

T1 - Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates

AU - Thuluvath, Avesh J.

AU - Duarte-Rojo, Andres

AU - Lai, Jennifer C.

AU - Peipert, John

AU - Dietch, Zachary C.

AU - Siddiqui, Osama

AU - Morrissey, Sheila

AU - Belfanti, Kimberly

AU - Zhao, Lihui

AU - Guo, Kexin

AU - Nizamuddin, Mohammad

AU - Polineni, Praneet

AU - Levitsky, Josh

AU - Flores, Ann Marie

AU - Ladner, Daniela P.

PY - 2024/2/1

Y1 - 2024/2/1

N2 - 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 (r = -0.54, P < 0.001) and 4-m gait speed (r = 0.48, P < 0.001). The mean hospitalization rate was 1.1 d admitted per month. After adjusting for age, sex, and model of end-stage liver disease-sodium, patient-reported physical function-predicted hospitalization rate (P = 0.001). 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.

AB - 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 (r = -0.54, P < 0.001) and 4-m gait speed (r = 0.48, P < 0.001). The mean hospitalization rate was 1.1 d admitted per month. After adjusting for age, sex, and model of end-stage liver disease-sodium, patient-reported physical function-predicted hospitalization rate (P = 0.001). 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.

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SN - 0041-1337

VL - 108

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EP - 497

JO - Transplantation

JF - Transplantation

IS - 2

ER -

Brief PROMIS Assessment Screens for Frailty and Predicts Hospitalizations in Liver Transplant Candidates

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