Frailty in end-stage liver disease:Understanding pathophysiology,tools for assessment,and strategies for management  

作　　者：Mazen Elsheikh Ahmed El Sabagh Islam B Mohamed Megha Bhongade Manal M Hassan Prasun Kumar Jalal 

机构地区：[1]Department of Gastroenterology and Hepatology,Baylor College of Medicine,Houston,TX 77030,United States [2]Department of Epidemiology,Division of Cancer Prevention and Population Sciences,The University of Texas,MD Anderson Cancer Center,Houston,TX 77030,United States

出　　处：《World Journal of Gastroenterology》2023年第46期6028-6048,共21页世界胃肠病学杂志（英文版）

摘　　要：Frailty and sarcopenia are frequently observed in patients with end-stage liver disease.Frailty is a complex condition that arises from deteriorations across various physiological systems,including the musculoskeletal,cardiovascular,and immune systems,resulting in a reduced ability of the body to withstand stressors.This condition is associated with declined resilience and increased vulnerability to negative outcomes,including disability,hospitalization,and mortality.In cirrhotic patients,frailty is influenced by multiple factors,such as hyperammonemia,hormonal imbalance,malnutrition,ascites,hepatic encephalopathy,and alcohol intake.Assessing frailty is crucial in predicting morbidity and mortality in cirrhotic patients.It can aid in making critical decisions regarding patients’eligibility for critical care and transplantation.This,in turn,can guide the development of an individualized treatment plan for each patient with cirrhosis,with a focus on prioritizing exercise,proper nutrition,and appropriate treatment of hepatic complications as the primary lines of treatment.In this review,we aim to explore the topic of frailty in liver diseases,with a particular emphasis on pathophysiology,clinical assessment,and discuss strategies for preventing frailty through effective treatment of hepatic complications.Furthermore,we explore novel assessment and management strategies that have emerged in recent years,including the use of wearable technology and telemedicine.

关 键 词：End-stage liver disease FRAILTY Liver cirrhosis MALNUTRITION SARCOPENIA 

分 类 号：R575[医药卫生—消化系统]