Evidence map›Paper›PMID 34558844›Full record

ArticleHepatology communications2022

Cognitive Impairment and Physical Frailty in Patients With Cirrhosis.

Kacey Berry, Andres Duarte-Rojo, Joshua D Grab, Michael A Dunn, Brian J Boyarsky, Elizabeth C Verna, Matthew R Kappus, Michael L Volk, Mara McAdams-DeMarco, Dorry L Segev and 7 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Hepatology communications, 2022. 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
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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

17 authors.

Kacey BerryDivision of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0001-8422-9379
Andres Duarte-RojoCenter for Liver Diseases, Thomas A. Starzl Transplantation Institute and Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0002-5377-9295
Joshua D GrabDivision of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Michael A DunnCenter for Liver Diseases, Thomas A. Starzl Transplantation Institute and Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
Brian J BoyarskyDepartment of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Elizabeth C VernaCenter for Liver Disease and Transplantation, Columbia University Irving Medical Center, New York, NY, USA.
Matthew R KappusDivision of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0003-3365-5903
Michael L VolkDivision of Gastroenterology and Hepatology, and Transplantation Institute, Loma Linda University Health, Loma Linda, CA, USA.
Mara McAdams-DeMarcoDepartment of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Dorry L SegevDepartment of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Daniel R GangerDivision of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Daniela P LadnerComprehensive Transplant Center, Feinberg School of Medicine, Northwestern University Transplant Outcomes Research Collaborative, Northwestern University, Chicago, IL, USA.
Amy ShuiDivision of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Monica A TincopaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.ORCID 0000-0002-9954-8548
Robert S RahimiAnnette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Baylor Scott and White, Dallas, TX, USA.ORCID 0000-0002-2595-1852
Jennifer C LaiDivision of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.ORCID 0000-0003-2092-6380
from the Multi-Center Functional Assessment in Liver Transplantation (FrAILT) Study

Funding

UCSF Liver Core CenterP30DK026743 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer Y. Chen · 1986 to 2026
$30.7M
VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
NRSA Training CoreTL1TR001871 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SOMSOUK, MA · 2016 to 2025
$10.1M
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
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Frailty and Functional Status in Older Liver Transplant PatientsK23AG048337 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LAI, JENNIFER C. · 2014 to 2018
$911k
Aggressive Organ Procurement Organization Report Cards to Safely Increase Kidney TransplantationF32DK124941 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI BOYARSKY, BRIAN · 2020 to 2020
$81k
NCATS NIH HHS TL1 TR001871NIA NIH HHS K23 AG048337NIA NIH HHS P30 AG044281NIA NIH HHS R01 AG059183NIDDK NIH HHS F32 DK124941NIDDK NIH HHS K24 DK101828NIDDK NIH HHS P30 DK026743
6 · The paper itself

Abstract

Physical frailty and impaired cognition are common in patients with cirrhosis. Physical frailty can be assessed using performance-based tests, but the extent to which impaired cognition may impact performance is not well characterized. We assessed the relationship between impaired cognition and physical frailty in patients with cirrhosis. We enrolled 1,623 ambulatory adult patients with cirrhosis waiting for liver transplantation at 10 sites. Frailty was assessed with the liver frailty index (LFI; "frail," LFI ≥ 4.4). Cognition was assessed at the same visit with the number connection test (NCT); continuous "impaired cognition" was examined in primary analysis, with longer NCT (more seconds) indicating worse impaired cognition. For descriptive statistics, "impaired cognition" was NCT ≥ 45 seconds. Linear regression associated frailty and impaired cognition; competing risk regression estimated subhazard ratios (sHRs) of wait-list mortality (i.e., death/delisting for sickness). Median NCT was 41 seconds, and 42% had impaired cognition. Median LFI (4.2 vs. 3.8) and rates of frailty (38% vs. 20%) differed between those with and without impaired cognition. In adjusted analysis, every 10-second NCT increase associated with a 0.08-LFI increase (95% confidence interval [CI], 0.07-0.10). In univariable analysis, both frailty (sHR, 1.63; 95% CI, 1.43-1.87) and impaired cognition (sHR, 1.07; 95% CI, 1.04-1.10) associated with wait-list mortality. After adjustment, frailty but not impaired cognition remained significantly associated with wait-list mortality (sHR, 1.55; 95% CI, 1.33-1.79). Impaired cognition mediated 7.4% (95% CI, 2.0%-16.4%) of the total effect of frailty on 1-year wait-list mortality. Conclusion: Patients with cirrhosis with higher impaired cognition displayed higher rates of physical frailty, yet frailty independently associated with wait-list mortality while impaired cognition did not. Our data provide evidence for using the LFI to understand mortality risk in patients with cirrhosis, even when concurrent impaired cognition varies.

Indexed as

AgedCognitive DysfunctionFemaleFrailtyHumansLiver CirrhosisLiver TransplantationMaleMiddle AgedProspective StudiesWaiting Lists

Identifiers

PMID34558844
PMCPMC8710786

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.