Turkiye Klinikleri Journal of Medical Sciences

.: REVIEW
Frailty Predicts Outcomes and Prognosis of Liver Cirrhosis Patients: A Meta-Analysis and Systematic Review
Kırılganlık Karaciğer Sirozu Hastalarının Sonuçlarını ve Prognozunu Öngördürüyor: Bir Metaanaliz ve Sistematik Derleme
Putu Ijiya DANTA AWATARAa, Adi KUNCOROa, Levrita Nindya POETRIa, Nuansa Firgie PARAMITAa , Jonny Karunia FAJARa,b, Syifa MUSTIKAa,b,c
aFaculty of Medicine, Universitas Brawijaya, Malang, Indonesia
bInternal Medicine Department, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
cDepartment of Gastroenterohepatology, Dr. Saiful Anwar General Hospital Malang, Malang, Indonesia
Turkiye Klinikleri J Med Sci. 2022;42(3):221-9
doi: 10.5336/medsci.2021-87150
Article Language: EN
Full Text
ABSTRACT
 Studies have assessed the role of frailty in estimating the prognosis of liver cirrhosis patients; however, conflicting findings were found across the reports. The focus of this study was to look into the relationship between frailty and the prognosis of patients with liver cirrhosis. We performed a meta-analysis between August 2020 and January 2021. Data were obtained from articles present in the Web of Science, Embase, and PubMed. The comparison between frailty and the outcomes [ascites, hepatic encephalopathy, mortality, and the model for end-stage liver disease (MELD) score] among liver cirrhosis patients was calculated using a Z test. We included 1,318 liver cirrhosis patients with frailty and 3,579 patients without frailty, retrieved from 9 papers. Frail patients used to have a 1.5-fold and 1.94-fold greater chance of developing ascites [relative risk (RR): 1.65; 95% confidence interval (CI): 1.29, 2.13] and hepatic encephalopathy (RR: 1.94; 95% CI: 1.39, 2.70), respectively, compared with patients without frailty among liver cirrhosis patients. We also revealed that liver cirrhosis patients with frailty had higher odds of mortality than patients without frailty (RR: 2.10; 95% CI: 1.33, 3.34). Furthermore, a higher MELD score was noted in liver cirrhosis patients with frailty than in patients without frailty (mean difference: 2.07; 95% CI: 1.08, 3.07). Frailty is an important predictor of ascites, hepatic encephalopathy, mortality, and a higher MELD score among liver cirrhosis patients.

Keywords: Liver cirrhosis; frailty; clinical outcome; prognosis
ÖZET
 Karaciğer sirozu hastalarının prognozunu tahmin etmede kırılganlığın rolü çeşitli çalışmalarda değerlendirilmiştir ancak bulgular arasında çelişkiler söz konusudur. Bu çalışmada, karaciğer sirozu olan hastalarda kırılganlık ile prognoz arasındaki ilişkiyi incelemek amaçlandı. Ağustos 2020-Ocak 2021 arasında bir metaanaliz gerçekleştirildi. Veriler, Web of Science, Embase ve PubMed'de bulunan makalelerden elde edildi. Karaciğer sirozu hastalarında kırılganlık ve sonuçlar [asit, hepatik ensefalopati, mortalite ve son dönem karaciğer hastalığı modeli (model for endstage liver disease 'MELD') skoru] arasındaki karşılaştırma bir Z testi kullanılarak hesaplandı. Dokuz çalışmada yer alan, kırılganlığı olan 1.318 ve kırılganlığı olmayan 3.579 karaciğer sirozu hastası araştırmaya dâhil edildi. Kırılgan hastalarda, kırılgan olmayan hastalara kıyasla asit ve hepatik ensefalopati gelişme olasılığının sırasıyla 1,5 kat [rölatif risk (RR): 1,65; %95 güven aralığı (GA): 1,29, 2,13] ve 1,94 kat (RR: 1,94; %95 GA: 1,39, 2,70) daha fazla olduğu bulundu. Kırılgan karaciğer sirozu hastalarının, kırılgan olmayan hastalara göre daha yüksek mortalite olasılığına sahip olduğu da izlendi (RR: 2,10; %95 GA: 1,33, 3,34). Ayrıca kırılgan karaciğer sirozu hastalarında, kırılgan olmayanlara göre daha yüksek bir MELD skoru kaydedildi (ortalama fark: 2,07; %95 GA: 1,08, 3,07). Kırılganlık, karaciğer sirozu hastalarında asit, hepatik ensefalopati, mortalite ve daha yüksek MELD skoru için önemli bir öngördürücüdür.

Anahtar Kelimeler: Karaciğer sirozu; kırılganlık; klinik sonuç; prognoz
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4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com