Standardized measures of frailty predict hospital length of stay following orthotopic liver transplantation for hepatocellular carcinoma.

Overview

Frailty in liver transplant (LT) waitlisted patients has been shown to predict waitlist mortality. While not currently used to allocate organs, the relationship between preoperative frailty and postoperative outcomes following orthotopic LT needs further elucidation. We determined the frailty status of 50 OLT candidates listed for hepatocellular carcinoma (HCC) and examined relationships between frailty and outcomes on the waitlist and, if transplanted, 30-day mortality, hospital length of stay (LOS), ICU LOS, and several other secondary outcomes. The overall prevalence of frailty was 30%, and the median natural MELD score for patients was 13. The overall hospital LOS for the frail group was longer (14.5 days [IQR 12-19]) as compared to the non-frail group (8 days [IQR 7-13]); P = .015. Groups also differed in the time to their first PT session (6 days [IQR 4-15] for the frail vs 4 days [IQR 3-7] for the non-frail patients; P = .042). There was no statistically significant difference in other outcomes measures, including ICU LOS and 30-day mortality. Frailty in OLT patients with diagnosed HCC is a predictor of longer hospital stay and longer time to the first completed PT session independent of preoperative MELD scores.