Tuesday, January 23, 2018

Combating Frailty's Fatal Impact in Liver Disease

Advice for Combating Frailty's Fatal Impact in Liver Disease
Rowen K. Zetterman, MD
January 22, 2018

Dr Rowen Zetterman on the various ways in which frailty imperils outcomes in liver disease, and the most useful strategies for addressing them.

Diagnosing Frailty in Patients With Cirrhosis 
Frailty also increases the risk for morbidity and mortality in patients with chronic liver disease.[6,7] Sarcopenia (loss of muscle mass) and frailty may not directly correlate with the clinical severity of liver disease, and must be carefully sought to establish the diagnosis.[6]

Using observation alone to diagnose frailty in patients with end-stage liver disease is inadequate, because frailty may not be recognized by clinicians until late in the course of disease or simply be overlooked in well-groomed patients, some women, and those with obesity. Using body mass index as an indicator of malnutrition and frailty can be deceptive, because it fails to consider the functional issues of frailty. Multiple clinical measures of frailty have been published using a combination of findings, such as unintentional weight loss, reduced walking or gait speed, muscle weakness, and evidence of reduced physical activity.[1,2,7,8]

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