Journal of Clinical Hepatology
This article investigates the predictive value of the Fried Frailty Phenotype (FFP), Liver Frailty Index (LFI), and Short Physical Performance Battery (SPPB) for all-cause mortality and composite endpoint events (death + decompensation) in patients with liver cirrhosis over two years. The study included 277 patients with liver cirrhosis and found that the prevalence of frailty assessed by the three tools was 37.2%, 22.4%, and 20.2%, respectively, and the clinical outcomes of the frailty group were significantly worse. ROC analysis showed that FFP was superior to the Child-Pugh score in predicting all-cause mortality (AUC=0.79) and composite endpoints (AUC=0.75) (P<0.05), while LFI and SPPB, although with higher AUC, did not show statistically significant differences. NRI and IDI analysis indicated that combined frailty assessment could significantly improve risk stratification ability (e.g., NRI for all-cause mortality=0.67, IDI=0.10, P<0.001) when combined with the Child-Pugh score. Calibration curves confirmed the high predictive accuracy of the combined model. The innovation lies in the systematic comparison of the independent predictive efficacy of the three frailty tools and the verification that their combined application with the traditional Child-Pugh score can significantly optimize prognostic assessment, with FFP performing optimally and suggesting its inclusion in the standard management process for liver cirrhosis. Additionally, the LFI combined model has greater potential for dynamic monitoring of intervention effects.
This study systematically evaluated the prognostic predictive value of three frailty assessment tools (FFP, LFI, SPPB) in patients with liver cirrhosis, revealing the close association between frailty and adverse clinical outcomes. The study found that frailty defined by different tools could independently predict all-cause mortality and composite endpoint events, with FFP showing superior predictive efficacy compared to the Child-Pugh score (AUCs of 0.79 vs 0.69, P=0.032), and combined frailty scores significantly improving the predictive accuracy of traditional models (AUC increased to 0.81~0.82). In addition, frailty patients are more likely to have nutritional risks, complications, and a decline in functional status, indicating the importance of frailty as a comprehensive physiological reserve indicator. This study provides empirical support for incorporating frailty assessment into clinical management of liver cirrhosis, helping to identify high-risk populations early, optimize risk stratification and intervention strategies. Despite limitations such as single-center and limited sample size, the results have important clinical application value.
Objective: To investigate the value of Fried Frailty Phenotype (FFP), liver frailty index (LFI), and Short Physical Performance Batte…
