Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Frailty in Patients with Ascites & Hepatic Encephalopathy

Gastroenterology; ePub 2019 Jan 19; Lai, et al

In patients with ascites or hepatic encephalopathy (HE), frailty is a prevalent complication of cirrhosis that is observed more frequently and independently associated with waitlist mortality, a new study found. Adults without hepatocellular carcinoma (HCC) who were on the liver transplant waitlist at 9 centers in the US (n=1,044) were evaluated using the liver frailty index (LFI) scores of ≥4.5 indicated that patients were frail. Researchers investigated associations between LFI scores, ascites, and HE and mortality. They found:

  • Of study participants, 36% had ascites, 41% had HE, and 25% were frail.
  • The odds of frailty were higher for patients with ascites or HE vs those without these features.
  • Higher proportions of frail patients with ascites or HE died while on the waitlist compared to those who were not frail.
  • HE and frailty were associated with waitlist mortality.


Lai JC, Rahimi R, Verna EC, et al. Frailty associated with waitlist mortality independent of ascites and hepatic encephalopathy in a multi-center study. [Published online ahead of print January 19, 2019]. Gastroenterology. doi:10.1053/j.gastro.2019.01.028.

Must Reads in Endoscopy, Pancreas, & Biliary Tract

Gender Differences in Patients Hospitalized with Cirrhosis, J Clin Gastroenterol; ePub 2019 Feb 22; Rubin, et al

POC Test for Identifying Viraemic HCV Infection, J Hepatol; ePub 2019 Feb 21; Freiman, et al

Frailty in Patients with Ascites & Hepatic Encephalopathy, Gastroenterology; ePub 2019 Jan 19; Lai, et al

Hypercholesterolemia & Statin Exposure in Cirrhosis, Gastroenterology; ePub 2019 Jan 18; Kaplan, et al

Response to UDCA Treatment in PBC Patients, Clin Gastroenterol Hepatol; ePub 2019 Jan 4; Cheung, et al