Frailty is independently associated with increased hospitalisation days in patients on the liver transplant waitlist

Table 1 Baseline demographics of waitlisted cohort enrolled into the FrAILT study stratified by frail (Fried Frailty Index ≥ 3) and non-Frail (Fried Frailty Index < 3)

Characteristic	Overall (n = 587)	Frail (n = 184)	Non-frail (n = 399)	P value
Age (yr)	60 (53-64)	60 (54-64)	59 (52-63)	0.03
Male	64%	60%	66%	0.12
BMI (kg/m2)	28 (25-33)	28 (25-33)	28 (25-33)	0.74
MELD (points)	15 (12-18)	16 (14-20)	14 (12-17)	< 0.001
Albumin (g/dL)	3.0 (2.6-3.5)	2.9 (2.5-3.2)	3.2 (2.7-3.6)	< 0.001
Sodium (nmol/L)	137 (134-139)	135 (132-138)	137 (135-139)	< 0.001
HCC	33%	25%	36%	0.004
Numbers connection test (s)	40 (30-54)	46 (34-61)	38 (29-51)	< 0.001
Ascites	28%	40%	22%	< 0.001
HIV	2.9%	2.7%	3.0%	0.85
Diabetes	31%	32%	30%	0.46

BMI: Body mass index; MELD: Model for end stage liver disease; HCC: Hepatocellular carcinoma; HIV: Human immunodeficiency virus.

Table 2 Significant differences between patients hospitalised within 12 mo and non-hospitalised individuals

Characteristic	Hospitalised, n = 251	Non-hospitalised, n = 336	P value
Age (yr)	59 (53; 63)	60 (55; 64)	0.02
Male gender	57%	69%	0.003
MELD score	16 (13; 20)	14 (11; 17)	< 0.001
Albumin (g/dL)	2.8 (2.5; 3.2)	3.2 (2.8; 3.7)	< 0.001
Sodium (mmol/L)	136 (133; 139)	137 (135; 139)	0.002
Fried Frailty Index	2 (1; 3)	2 (1; 2)	< 0.001
SPPB score	11 (9; 12)	11 (10; 12)	< 0.001
Chair stands per second	0.4 (0.3-0.5)	0.5 (0.4-0.6)	< 0.001
Walk speed (m/s)	1.2 (0.9-1.4)	1.3 (1.1-1.6)	< 0.001
Handgrip strength (kg)	27.7 (21.7; 35.3)	32.7 (25.0; 40.9)	< 0.001
Encephalopathy (numbers connection score)	41.6 (31.7; 57.3)	38.3 (29.4; 52.1)	0.008

MELD: Model for end stage liver disease; SPPB: Short physical performance battery.

Table 3 Significant predictors of hospitalisation days per 12 mo on multivariable analysis

Characteristic	IRR (95%CI), n = 583	P value
Frail by Fried Frailty Index	1.21 (1.02, 1.44)	0.03
MELD score	1.10 (1.06, 1.15)	< 0.001
Albumin (g/L)	0.43 (0.31, 0.61)	< 0.001
Female sex	1.85 (1.22, 2.81)	0.004

Frail-Fried Frailty Index ≥ 3. IRR: Incidence rate ratios; MELD: Model for end-stage liver disease.

Table 4 Predictors of infection on bivariable analysis (accounting for observation time)

Characteristic	OR (95%CI)	P value
Albumin (g/dL)	0.40 (0.27-0.60)	< 0.001
MELD score	1.07 (1.02-1.11)	0.005
HCC (yes vs no)	0.60 (0.36-0.99)	0.046
Chair stands (completion of 5 chair stands within 10 s)	0.32 (0.11-0.98)	0.046
Age (yr)	0.98 (0.96-1.0)	0.05
Frail (SPPB score ≤ 9)	1.54 (0.94-2.50)	0.08
Frail (Fried frailty Index ≥ 3)	1.49 (0.94-2.36)	0.09
Sodium	0.96 (0.90-1.01)	0.10
Hepatic encephalopathy (numbers connection > 45 s)	0.72 (0.46-1.14)	0.16

MELD: Model for end stage liver disease; HCC: Hepatocellular carcinoma; SPPB: Short physical performance battery.