Clinical burden of physical frailty in patients evaluated for liver transplantation: A retrospective cohort study

Table 4 Univariable and multivariable regression analysis for frailty categories (robust, pre-frail, frail) and clinical outcomes

Clinical outcome across frailty groups total cohort (n = 266)	Univariable analysis		Multivariable analysis
	Beta value/co-efficient (SE)	OR (95%CI)	P value	Beta value/co-efficient (SE)	OR (95%CI)	P value
Pre transplant
LT recipient (yes/total n = 144/266)
Frail (n = 14/37)	-1.16 (0.45)	0.33 (0.13-0.76)	0.010	-1.44 (0.49)	0.24 (0.90-0.62)	0.003
Pre-frail (n = 97/179)	-0.50 (0.33)	0.61 (0.32-1.17)	0.140	-0.62 (0.35)	0.54 (0.27-1.08)	0.040
Robust (n = 33/50)	Reference	Reference	Reference	Reference	Reference	-
Unplanned hospital admission (yes/total n = 105/266)
Frail (n = 21/37)	1.79 (0.50)	6.00 (2.27-15.79)	< 0.001	1.12 (0.54)	3.07 (1.06-8.90)	0.04
Pre-frail (n = 75/179)	1.19 (0.40)	3.29 (1.51-7.17)	0.003	0.91 (0.42)	2.49 (1.08-5.72)	0.030
Robust (n = 9/50)	Reference	Reference	-	Reference	Reference	-
Early post-transplant complications
Grade ≥ 3 post op complication1,2 (yes/total n = 72/144)
Frail (n = 7/14)	0.43 (0.64)	1.54 (0.44-5.42)	0.500	0.09 (0.70)	1.10 (0.28-4.28)	0.900
Pre-frail (n = 52/97)	0.58 (0.41)	1.78 (0.80-3.97)	0.160	0.33 (0.43)	1.39 (0.60-3.25)	0.400
Robust (n = 13/33)	Reference	Reference	-	Reference	Reference	-
ICU LOS > 4 days3 (yes/total n = 13/142)
Frail (n = 4/14)	1.79 (0.94)	6.00 (0.95-37.86)	0.060	2.24 (1.09)	9.45 (1.11-80.82)	0.040
Pre-frail (n = 7/96)	0.21 (0.80)	1.18 (0.23-5.99)	0.840	0.20 (0.86)	1.22 (0.22-6.65)	0.810
Robust (n = 2/32)	Reference	Reference	-	Reference	Reference	-
LOS > 18 days3 (yes/total n = 28/142)
Frail (n = 5/14)	2.12 (0.92)	8.33 (1.38-50.47)	0.020	1.90 (0.96)	6.66 (1.01-43.80)	0.050
Pre-frail (n = 21/96)	1.44 (0.83)	4.20 (0.93-19.03)	0.060	1.31 (0.79)	3.71 (0.80-17.28)	0.100
Robust (n = 2/32)	Reference	Reference	-	Reference	Reference	-

¹Clavien-Dindo classification (category 3; requirement for re-operation, category 4; requirement for extended intensive care unit stay or ventilation in intensive care unit, category 5; death).

²n = 144 including 2 who died during transplant but have been included in transplant complications.

³n = 1.

The analysis represent 10 points change in the liver frailty index score. P values are reported to three decimal places, with P < 0.001 shown for values below this threshold. Multivariable analysis was adjusted for cofounders of age, sex, presence of hepatocellular carcinoma and model for end-stage liver disease score. LT: Liver transplantation; LOS: Length of stay; ICU: Intensive care unit; OR: Odds ratio; CI: Confidence interval.