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

World Journal of Gastroenterology 2023年第46期29卷 6028-6048页

作者： mazen elsheikh Ahmed El Sabagh Islam B Mohamed Megha Bhongade Manal M Hassan Prasun Kumar Jalal Department of Gastroenterology and Hepatology Baylor College of MedicineHoustonTX 77030United States Department of Epidemiology Division of Cancer Prevention and Population SciencesThe University of TexasMD Anderson Cancer CenterHoustonTX 77030United States

Frailty and sarcopenia are frequently observed in patients with end-stage liver *** 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 *** condition is associated with declined resilience and increased vulnerability to negative outcomes,including disability,hospitalization,and *** cirrhotic patients,frailty is influenced by multiple factors,such as hyperammonemia,hormonal imbalance,malnutrition,ascites,hepatic encephalopathy,and alcohol *** frailty is crucial in predicting morbidity and mortality in cirrhotic *** can aid in making critical decisions regarding patients’eligibility for critical care and ***,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 *** 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 ***,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

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