Beta-blockers and physical frailty in patients with end-stage liver disease

Table 1 Patient demographics

Characteristics	All	On beta blockers	Not on beta blockers	P value
	n = 344	n = 181 (53%)	n = 163 (47%)
Age (yr)	60 (54-64)	61 (54-65)	60 (54-63)	0.16
Female	35%	25%	46%	< 0.001
Race/ethnicity				0.26
Non-Hispanic White	57%	56%	58%
Black	4%	3%	6%
Hispanic White	27%	30%	23%
Asian	7%	5%	8%
Other	6%	7%	5%
Etiology of liver disease				0.39
Hepatitis C	50%	51%	49%
Alcohol	15%	15%	15%
Nonalcoholic steatohepatitis	13%	15%	11%
Autoimmune/cholestatic	11%	9%	14%
Hepatitis B	4%	2%	6%
Other	6%	7%	6%
HCC	27%	32%	22%	0.04
BMI (kg/m2)	28.4 (24.9-33.0)	29.3 (25.8-33.7)	27.7 (24.2-31.8)	0.0081
Medical co-morbidities
Hypertension	44%	48%	40%	0.12
Diabetes	32%	36%	27%	0.06
Coronary artery disease	7%	10%	4%	0.04
Lab tests
Lab MELD	15 (12-18)	15 (13-18)	15 (12-18)	0.55
Total bilirubin (mg/dL)	2.3 (1.6-3.4)	2.3 (1.5-3.2)	2.4 (1.7-3.6)	0.41
INR	1.4 (1.2-1.6)	1.4 (1.3-1.6)	1.4 (1.2-1.6)	0.54
Creatinine (mg/dL)	0.9 (0.8-1.2)	1 (0.8-1.2)	0.9 (0.7-1.2)	0.0034
Sodium (mEq/L)	137 (134-139)	137 (135-139)	137 (134-139)	0.75
Ascites
Mild-moderate	30%	30%	30%	0.40
Refractory	3%	4%	2%
Hepatic encephalopathy1	21%	22%	21%	0.86
Child Pugh Score				0.89
A	19%	18%	20%
B	60%	60%	59%
C	21%	22%	21%

¹Defined as a Numbers Connection test > 60 s. HCC: Hepatocellular carcinoma; BMI: Body mass index; MELD: Model for End Stage Liver Disease.

Table 2 Comparison of metrics of physical frailty by beta-blocker use

Outcome	On beta blockers	Not on beta blockers	P value
	n = 181 (53%)	n = 163 (47%)
Liver frailty index1	3.75 (3.37-4.15)	3.64 (3.23-4.04)	0.04
Chair stands (s)	12.5 (10-16.2)	10.9 (8.3-13.2)	0.003
Grip strength (kg)	33.3 (24.3-40)	29 (22-37)	0.03
Balance (s)	30 (30-30)	30 (26.6-30)	0.20
LFI Frail	14%	14%	0.98
LFI Robust	16%	25%	0.06
Exhaustion	51%	52%	0.89
MNLTPA frailty	58%	60%	0.69

¹Five missing data points. LFI: Liver frailty index; MNLTPA: Minnesota leisure time physical activity scale.

Table 3 Competing risks survival analysis

Variable	Univariable SHR (95%CI)	Multivariable SHR (95%CI)
	P value	P value
Being on a Beta Blocker	0.57 (0.38-0.85)	0.55 (0.36-0.83)
	0.006	0.005
Liver Frailty Index	1.52 (1.13-2.03)	1.35 (1.02-1.80)
	0.005	0.04
MELD score	1.03 (0.99-1.07)
	0.19
Creatinine	1.17 (1.07-1.28)	1.10 (1.00-1.22)
	0.001	0.006
Albumin	0.79 (0.56-1.12)
	0.18
Sodium	0.99 (0.95-1.04)
	0.76
HCC	0.80 (0.50-1.29)
	0.37
Ascites	0.98 (0.63-1.51)
	0.92
Age	1.02 (0.99-1.04)
	0.15
Gender (female)	1.09 (0.72-1.65)
	0.68
Hepatic encephalopathy	1.99 (1.30-3.05)	1.64 (1.05-2.57)
(> 60 s)	0.001	0.03

HCC: Hepatocellular carcinoma; MELD: Model for End Stage Liver Disease; SHR: subdistribution hazard ratio.