ArticleThe American journal of gastroenterology2016
Frailty as Tested by Gait Speed is an Independent Risk Factor for Cirrhosis Complications that Require Hospitalization.
Article in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
70 citing papers in PubMed, 4 syntheses or guidelines pooled it, 140 citations in OpenAlex.
- Predictive Value of Frailty on Outcomes of Patients With Cirrhosis: Systematic Review and Meta-Analysis.JMIR medical informatics · 2025Pooled it
- Frailty and transplant-free survival of patients with liver cirrhosis: A meta-analysis.PloS one · 2024Pooled it
- Malnutrition, Frailty, and Sarcopenia in Patients With Cirrhosis: 2021 Practice Guidance by the American Association for the Study of Liver Diseases.Hepatology (Baltimore, Md.) · 2021Guideline
- ESPEN guideline on clinical nutrition in liver disease.Clinical nutrition (Edinburgh, Scotland) · 2019Guideline
- Home exercise, branched-chain amino acids, and probiotics improve frailty in cirrhosis: A randomized clinical trial.Hepatology communications · 2024Trial
- Branched-chain amino acids supplementation improves liver frailty index in frail compensated cirrhotic patients: a randomized controlled trial.BMC gastroenterology · 2023Trial
- Impact of physical activity on clinical outcomes in patients with liver cirrhosis: a prospective observational cohort study.Scientific reports · 2026Observational
- Prognostic Significance of Frailty in Liver Cirrhosis Patients: A Prospective Single-Center Study.Journal of clinical medicine · 2026Article
- Current management strategies for sarcopenia and frailty in cirrhosis: Missing link in transplant candidacy.World journal of hepatology · 2026Review
- Frailty in Hepatocellular Carcinoma: An Unsettled Clinical Challenge.Current oncology (Toronto, Ont.) · 2026Review
- White matter integrity and motor function: a link between cerebral myelination and longitudinal changes in gait speed in aging.GeroScience · 2025Article
- Home-based LIver FrailTy Intervention (LIFT) in Transplant Candidates: A Feasibility Study.Transplantation · 2025Article
- Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study.Scientific reports · 2025Article
- Home-based EXercise and motivAtional programme before and after Liver Transplantation (EXALT): study protocol for phase II two-centre, randomised controlled trial.BMJ open gastroenterology · 2024Article
- Frailty in liver transplantation: Exploring prescribing exercise as medicine to improve patient outcomes.Liver international : official journal of the International Association for the Study of the Liver · 2024Review
- Frailty after Liver Transplantation: A Complex Unexplored Issue.Journal of clinical medicine · 2024Review
- Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management.World journal of gastroenterology · 2023Review
- Exercise training as an intervention for frailty in cirrhotic patients on the liver transplant waiting list: A systematic review.World journal of hepatology · 2023Article
- Use of Branched-Chain Amino Acids as a Potential Treatment for Improving Nutrition-Related Outcomes in Advanced Chronic Liver Disease.Nutrients · 2023Review
- Fat mass: a novel digital biomarker for remote monitoring that may indicate risk for malnutrition and new complications in decompensated cirrhosis.BMC medical informatics and decision making · 2023Article
10 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFrailty is a known risk factor for major life-threatening liver transplant complications, deaths, and waitlist attrition. Whether frailty indicates risk for adverse outcomes in cirrhosis short of lethality is not well defined. We hypothesized that clinical measurements of frailty using gait speed and grip strength would indicate the risk of subsequent hospitalization for the complications of cirrhosis.
methodsWe assessed frailty as gait speed and grip strength in a 1-year prospective study of 373 cirrhotic patients evaluated for or awaiting liver transplantation. We determined its association with the outcome of subsequent hospital days/100 days at risk for 7 major complications of cirrhosis. We tested potential covariate influences of Model for Endstage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores, age, sex, height, depression, narcotic use, vitamin D deficiency, and hepatocellular carcinoma using multivariable modeling.
resultsPatients experienced 2.14 hospital days/100 days at risk, or 7.81 days/year. Frailty measured by gait speed was a strong risk factor for hospitalization for all cirrhosis complications. Each 0.1 m/s gait speed decrease was associated with 22% greater hospital days (P<0.001). Grip strength showed a similar but nonsignificant association. Gait speed remained independently significant when adjusted for MELD, CTP, and other covariates. At hospital costs of $4,000/day, patients with normal 1 m/s gait speed spent 6.2 days and $24,800/year; patients with 0.5 m/s speed spent 21.2 days and $84,800/year; and patients with 0.25 m/s speed spent 40.2 days and $160,800/year.
conclusionsFrailty as measured by gait speed is an independent and potentially modifiable risk factor for cirrhosis complications requiring hospitalization. The potential clinical value of frailty measurements to help define such risk merits broader evaluation.
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