Does the change in Liver Frailty Index over the first week of hospitalisation predict mortality in patients with acute-on-chronic liver failure? A prospective cohort study from a Slovak liver centre

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F25%3A43928544" target="_blank" >RIV/00216208:11120/25:43928544 - isvavai.cz</a>

Result on the web

<a href="https://doi.org/10.1136/bmjopen-2025-100171" target="_blank" >https://doi.org/10.1136/bmjopen-2025-100171</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1136/bmjopen-2025-100171" target="_blank" >10.1136/bmjopen-2025-100171</a>

Result language

angličtina

Original language name

Does the change in Liver Frailty Index over the first week of hospitalisation predict mortality in patients with acute-on-chronic liver failure? A prospective cohort study from a Slovak liver centre

Original language description

Objective Hospital admissions for advanced chronic liver disease (ACLD) are associated with increased mortality, disability, a decline in quality of life and significant economic costs. Being admitted to the hospital usually indicates a triggering event that disrupted a previously stable condition, leading to decompensation or complications of ACLD. The most acute and severe manifestation of this imbalance is acute-on-chronic liver failure (ACLF), a syndrome representing a critical juncture. Reliable prognostic stratification of patients admitted with ACLF could facilitate the systematic delivery of tailored care, ranging from palliative care to intensive interventions like extracorporeal liver support devices and prioritised liver transplantation. Disease-specific prognostic tools, such as the Model for End-Stage Liver Disease score, are effective but have limitations, particularly in reflecting a patient&apos;s potential for recovery. The concept of the body&apos;s functional reserve in the context of ACLD/ACLF is gaining attention, with the Liver Frailty Index (LFI) potentially emerging as a recommended diagnostic tool.Methods Patients were selected from our cirrhosis registry (RH7). The LFI serves as an indicator of the patient&apos;s prognosis. The LFI measurement takes place at two time intervals: on the patient&apos;s admission and after 7 days of hospitalisation.Results Our RH7 registry included 154 patients (15.1%) who were diagnosed with ACLF. The primary cause of the underlying ACLD was alcohol-associated liver disease in the majority (79.8%) of cases. The mean value of LFI at admission was 4.50 (+/- 0.94). When patients with liver cirrhosis were categorised into three subgroups based on the LFI on day 7, survival exhibited a statistically significant decrease (p &lt;= 0.05) across all three ACLF grades. This decline in survival was observed from the &apos;improved LFI&apos; cohort, through the &apos;stable LFI&apos; group, to the &apos;worsened LFI&apos; group.Conclusion The impact of day 7 LFI on the survival of patients with ACLF is notable. Nevertheless, it does not markedly enhance the predictive capability of the LFI assessed on admission. Consequently, the initial LFI on day 1 continues to be the most valuable and commonly used instrument for promptly recognising individuals with ACLF.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30219 - Gastroenterology and hepatology

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

BMJ Open

ISSN

2044-6055

e-ISSN

2044-6055

Volume of the periodical

15

Issue of the periodical within the volume

5

Country of publishing house

GB - UNITED KINGDOM

Number of pages

10

Pages from-to

e100171

UT code for WoS article

001498185800001

EID of the result in the Scopus database

2-s2.0-105006848556