Original Article
J Frailty Sarcopenia Falls 2023 Jun; 8(2):83-93 Copied!
10.22540/JFSF-08-083 Copied!
Frailty as a risk-stratification tool in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS)
- Department of Hepatology, Liver Institute Northwest, Seattle, USA
- Department of Internal Medicine, University of California, San Francisco, Fresno, USA
- Department of Public Health, Icahn School of Medicine, Mount Sinai, New York, USA
- Dayanand Medical College and Hospital, India
- Department of Internal Medicine, Orange Park Medical Center, Orange Park, Florida, USA
- Shri Guru Ram Das Medical College, India
- Ross University School of Medicine, Barbados, USA
- Department of Gastroenterology and Hepatology, University of California, San Francisco, Fresno, USA
- * Equal contribution
Keywords:
Abstract Objectives The concept of frailty has gained importance, especially in patients with liver disease. Our study systematically investigated the effect of frailty on post-procedural outcomes in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS). Methods We used National Inpatient Sample(NIS) 2016-2019 data to identify patients who underwent TIPS. Hospital frailty risk score (HFRS) was used to classify patients as frail (HFRS≥5) and non-frail (HFRS<5). The relationship between frailty and outcomes such as death, post-procedural shock, non-home discharge, length of stay (LOS), post-procedural LOS, and total hospitalization charges (THC) was assessed. Results A total of 13,700 patients underwent TIPS during 2016-2019. Of them, 5,995 (43.76%) patients were frail, while 7,705 (56.24%) were non-frail. There were no significant differences between the two groups based on age, gender, race, insurance, and income. Frail patients had higher mortality (15.18% vs. 2.07%, p<0.001), a higher incidence of non-home discharge (53.38% vs. 19.08%, p<0.001), a longer overall LOS (12.5 days vs. 3.35,p<0.001), longer post-procedural stay (8.2 days vs. 3.4 days, p<0.001), and higher THC ($240,746.7 vs. $121,763.1, p<0.001) compared to the non-frail patients. On multivariate analysis, frail patients had a statistically significant higher risk of mortality (aOR-3.22, 95% CI-1.98- 5.00, p<0.001). Conclusion Frailty assessment can be beneficial in risk stratification in patients undergoing TIPS.