Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study
Abstract Frailty and fractures are closely associated with adverse clinical outcomes. This retrospective study investigated the prognostic impact of frailty, prevalent fractures, and the coexistence of both in patients with cirrhosis. Frailty was defined according to the Fried frailty phenotype crit...
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Nature Portfolio
2025-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-83984-2 |
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| author | Takashi Niwa Chisato Saeki Mitsuru Saito Tsunekazu Oikawa Hiroshi Kamioka Tomoya Kanai Kaoru Ueda Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota |
| author_facet | Takashi Niwa Chisato Saeki Mitsuru Saito Tsunekazu Oikawa Hiroshi Kamioka Tomoya Kanai Kaoru Ueda Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota |
| author_sort | Takashi Niwa |
| collection | DOAJ |
| description | Abstract Frailty and fractures are closely associated with adverse clinical outcomes. This retrospective study investigated the prognostic impact of frailty, prevalent fractures, and the coexistence of both in patients with cirrhosis. Frailty was defined according to the Fried frailty phenotype criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. Prevalent fractures were assessed using questionnaires and lateral thoracolumbar spine radiographs. Cumulative survival rates were compared between the frailty and non-frailty groups, fracture and non-fracture groups, and all four groups stratified by the presence or absence of frailty and/or prevalent fractures. Among 189 patients with cirrhosis, 70 (37.0%) and 74 (39.2%) had frailty and prevalent fractures, respectively. The median observation period was 64.4 (38.6–71.7) months, during which 50 (26.5%) liver disease-related deaths occurred. Multivariate analysis identified frailty and prevalent fractures as significant independent prognostic factors in the overall cohort (p < 0.001 and p = 0.003, respectively). The cumulative survival rates were lower in the frailty or fracture groups than in the non-frailty or non-fracture groups, respectively, in the overall cohort and in patients with compensated and decompensated cirrhosis. Patients with both frailty and prevalent fractures showed the lowest cumulative survival rates, whereas those without these comorbidities showed the highest cumulative survival rates among the four stratified groups. Frailty and prevalent fractures were independently associated with mortality in patients with cirrhosis. Additionally, the coexistence of both comorbidities worsened the prognosis. |
| format | Article |
| id | doaj-art-a8682042147d43cd87ee4343efd4aba0 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-a8682042147d43cd87ee4343efd4aba02025-01-05T12:16:05ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-024-83984-2Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective studyTakashi Niwa0Chisato Saeki1Mitsuru Saito2Tsunekazu Oikawa3Hiroshi Kamioka4Tomoya Kanai5Kaoru Ueda6Masanori Nakano7Yuichi Torisu8Masayuki Saruta9Akihito Tsubota10Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDepartment of Orthopedic Surgery, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineDivision of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of MedicineResearch Center for Medical Science, The Jikei University School of MedicineAbstract Frailty and fractures are closely associated with adverse clinical outcomes. This retrospective study investigated the prognostic impact of frailty, prevalent fractures, and the coexistence of both in patients with cirrhosis. Frailty was defined according to the Fried frailty phenotype criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. Prevalent fractures were assessed using questionnaires and lateral thoracolumbar spine radiographs. Cumulative survival rates were compared between the frailty and non-frailty groups, fracture and non-fracture groups, and all four groups stratified by the presence or absence of frailty and/or prevalent fractures. Among 189 patients with cirrhosis, 70 (37.0%) and 74 (39.2%) had frailty and prevalent fractures, respectively. The median observation period was 64.4 (38.6–71.7) months, during which 50 (26.5%) liver disease-related deaths occurred. Multivariate analysis identified frailty and prevalent fractures as significant independent prognostic factors in the overall cohort (p < 0.001 and p = 0.003, respectively). The cumulative survival rates were lower in the frailty or fracture groups than in the non-frailty or non-fracture groups, respectively, in the overall cohort and in patients with compensated and decompensated cirrhosis. Patients with both frailty and prevalent fractures showed the lowest cumulative survival rates, whereas those without these comorbidities showed the highest cumulative survival rates among the four stratified groups. Frailty and prevalent fractures were independently associated with mortality in patients with cirrhosis. Additionally, the coexistence of both comorbidities worsened the prognosis.https://doi.org/10.1038/s41598-024-83984-2 |
| spellingShingle | Takashi Niwa Chisato Saeki Mitsuru Saito Tsunekazu Oikawa Hiroshi Kamioka Tomoya Kanai Kaoru Ueda Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study Scientific Reports |
| title | Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study |
| title_full | Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study |
| title_fullStr | Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study |
| title_full_unstemmed | Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study |
| title_short | Impact of frailty and prevalent fractures on the long-term prognosis of patients with cirrhosis: a retrospective study |
| title_sort | impact of frailty and prevalent fractures on the long term prognosis of patients with cirrhosis a retrospective study |
| url | https://doi.org/10.1038/s41598-024-83984-2 |
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