Evidence map›Paper›PMID 33437866›Full record

ArticleTransplantation direct2021

Evaluating the Associations Between the Liver Frailty Index and Karnofsky Performance Status With Waitlist Mortality.

Chelsea Q Xu, Frederick Yao, Yara Mohamad, Randi Wong, Dorothea Kent, Srilakshmi Seetharaman, Yanin Srisengfa, Jennifer C Lai

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplantation direct, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Update on the Complications and Management of Liver Cirrhosis.Medical sciences (Basel, Switzerland) · 2025
    Review
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Sarcopenia and Frailty in Liver Cirrhosis.Life (Basel, Switzerland) · 2021
    Review
  16. Article
  17. Nutritional Management of a Liver Transplant Candidate.Journal of clinical and experimental hepatology
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Chelsea Q XuDepartment of Medicine, University of California-San Francisco, San Francisco, CA.
Frederick YaoDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.
Yara MohamadDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.
Randi WongDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.
Dorothea KentDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.
Srilakshmi SeetharamanDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.
Yanin SrisengfaDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.
Jennifer C LaiDivision of Gastroenterology and Hepatology, Department of Medicine, University of California-San Francisco, San Francisco, CA.

Funding

The spectrum of cognitive impairment including Alzheimer’s Disease and Related Dementias after liver transplantationR01AG059183 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer C. Lai · 2018 to 2026
$9.9M
Frailty and Functional Status in Older Liver Transplant PatientsK23AG048337 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LAI, JENNIFER C. · 2014 to 2018
$911k
NIA NIH HHS K23 AG048337NIA NIH HHS R01 AG059183
6 · The paper itself

Abstract

Frailty has emerged as a critical determinant of mortality in patients with cirrhosis. Currently, the United Network for Organ Sharing registry only includes the Karnofsky Performance Status (KPS) scale, which captures a single component of frailty. We determined the associations between frailty, as measured by the Liver Frailty Index (LFI), and KPS with waitlist mortality.

methodsIncluded were 247 adult patients with cirrhosis listed for liver transplantation without hepatocellular carcinoma from February 2014 to June 2019, who underwent outpatient assessments using the LFI and KPS within 30 days of listing. "Frail" was defined using the established LFI cutoff of ≥4.4. Competing risk models assessed associations between the LFI and KPS with waitlist mortality (death/delisting for sickness).

resultsAt a median 8 months follow-up, 25 (10%) patients died/were delisted. In this cohort, median Model for End-Stage Liver Disease-Sodium was 17, LFI was 3.9 (interquartile range 3.4-4.5), and KPS was 80 (interquartile range 70-90). In multivariable analysis, LFI (sub-hazard ratio 1.07, per 0.1 unit; 95% confidence interval, 1.01-1.12) was associated with waitlist mortality while KPS was not (sub-hazard ratio 1.00, per 10 units; 95% confidence interval, 0.78-1.29).

conclusionsOur data suggest that frailty, as measured by the LFI, may be more appropriate at capturing mortality risk than KPS and provide evidence in support of using the LFI more broadly in clinical transplant practice in the outpatient setting.

Identifiers

PMID33437866
PMCPMC7793347

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.