ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2023
The tele-liver frailty index (TeLeFI): development of a novel frailty tool in patients with cirrhosis via telemedicine.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Two-Step Sequential Screening for Frailty in Patients With Chronic Liver Disease: A Triage Efficiency Study of Liver Frailty Index Components.Nursing open · 2026Article
- Frailty Increases Hospitalization Rates in an Ambulatory Cohort of Patients With Cirrhosis: The North American Consortium for the Study of End-Stage Liver Disease 3 Prospective Cohort.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Remote telerehabilitation for frailty management in liver transplant candidates: A feasible yet underutilized strategy.World journal of hepatology · 2026Article
- Frailty in Hepatocellular Carcinoma: An Unsettled Clinical Challenge.Current oncology (Toronto, Ont.) · 2026Review
- High Hospitalization Rates and Risk Factors Among Frail Patients With Cirrhosis: A 10-year Population-based Cohort Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025Article
- The Role of Patient-Reported Outcomes in Cirrhosis.The American journal of gastroenterology · 2025Review
- Home-based LIver FrailTy Intervention (LIFT) in Transplant Candidates: A Feasibility Study.Transplantation · 2025Article
- Proposal for a revised Barthel index classification based on mortality risk assessment in functional dependence for basic activities of daily living.Frontiers in public health · 2024Article
- Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management.World journal of gastroenterology · 2023Review
- Review
- Deciphering an expanding array of clinical and research frailty measures.Clinical liver diseaseReview
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
Frailty is a critical determinant of outcomes in cirrhosis patients. The increasing use of telemedicine has created an unmet need for virtual frailty assessment. We aimed to develop a telemedicine-enabled frailty tool (tele-liver frailty index). Adults with cirrhosis in the liver transplant setting underwent ambulatory frailty testing with the liver frailty index (LFI) in-person, then virtual administration of (1) validated surveys (eg, SARC-F and Duke Activity Status Index [DASI]), (2) chair stands, and (3) balance. Two models were selected and internally validated for predicting LFI ≥4.4 using: (1) Bayesian information criterion (BIC), (2) C-statistics, and (3) ease of use. Of 145 patients, the median (interquartile range) LFI was 3.7 (3.3-4.2); 15% were frail. Frail (vs not frail) patients reported significantly greater impairment on all virtually assessed instruments. We selected 2 parsimonious models: (1) DASI + chair/bed transfer (SARC-F) (BIC 255, C-statistics 0.78), and (2) DASI + chair/bed transfer (SARC-F) + virtually assessed chair stands (BIC 244, C-statistics 0.79). Both models had high C-statistics (0.76-0.78) for predicting frailty. In conclusion, the tele-liver frailty index is a novel tool to screen frailty in liver transplant patients via telemedicine pragmatically and may be used to identify patients who require in-person frailty assessment, more frequent follow-up, or frailty intervention.
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