Abstract：
Background: Stratifying patients with liver cirrhosis for risk of rehospitalization is challenging with established scoring systems for chronic liver disease. Frailty captures the physical characteristics of patients with cirrhosis. Its value for predicting short-term rehospitalizations in hospitalized patients remains to be defined. Methods: Eighty-three non-electively hospitalized patients with liver cirrhosis were analyzed in this study. Frailty was assessed during the last 48 h of hospital stay with the liver frailty index (LFI). Patients were followed for 30-day rehospitalization. Results: In total, 26 (31%) patients were rehospitalized within 30 days. The median LFI was 4.5, and 43 (52%) patients were identified as frail. Rehospitalized patients had a significant higher LFI compared to patients without a rehospitalization within 30 days. In multivariable analysis, LFI as a metric variable (OR 2.36, p = 0.02) and lower platelet count (OR 0.98, p < 0.01) were independently associated with rehospitalization. LFI and its subtest chair stands had the best discriminative ability to predict rehospitalization, with AUROCs of 0.66 and 0.67, respectively. An LFI cut-off of >4.62 discriminated best between patients with and without elevated risk for rehospitalization within 30 days. Conclusions: Measures of frailty could be useful to identify patients at higher risk for short-term rehospitalization.
摘要：
背景：对肝硬化患者的再住院风险进行分层是建立慢性肝病评分系统的挑战。虚弱捕获肝硬化患者的身体特征。其预测住院患者短期再住院的价值尚待确定。方法:对83例非择期住院肝硬化患者进行分析。在住院的最后48小时内使用肝脏虚弱指数（LFI）评估虚弱。随访患者30天再次住院。结果：总的来说，26例（31%）患者在30天内再次住院。中位LFI为4.5，43例（52%）患者被确定为虚弱。与30天内没有再次住院的患者相比，再次住院的患者的LFI明显更高。在多变量分析中，作为度量变量的LFI（OR2.36，p=0.02）和较低的血小板计数（OR0.98，p<0.01）与再住院独立相关。LFI及其子测试椅架具有预测再住院的最佳判别能力，AUROC分别为0.66和0.67。>4.62的LFI临界值在30天内有和没有增加的再住院风险的患者之间最好地区分。结论：虚弱的措施可能有助于识别短期再住院风险较高的患者。
