University of Toledo College of Medicine and Life Sciences Toledo, Ohio
Patel Manthanbhai, MD1, Eunice Kwak, MD2, Nahush Bansal, MD3, Hasan Al-Obaidi, MD1, Nooraldin Merza, MD1, Ali Nawras, MD4, Priyanaka Ahuja, MD5, Sudheer Dhoop, MD6, Muhammad Ali Ibrahim Kazi, MD7, Maram Albandak, MD8 1University of Toledo College of Medicine and Life Sciences, Toledo, OH; 2University of Toledo Health Sciences Campus, Toledo, OH; 3university of Toledo College of Medicine and Life Sciencesr, Toledo, OH; 4The University of Toledo, Toledo, OH; 5university of Toledo College of Medicine and Life Sciencesrsity, Toledo, OH; 6University of Toledo, Toledo, OH; 7Anne Arundel Medical Center, Annapolis, MD; 8university of Toledo College of Medicine and Life Sciencesrsityersi, Toledo, OH Introduction: Frailty is increasingly recognized as a determinant of poor outcomes in patients with cirrhosis, yet the nationwide prevalence and impact on health outcomes remain underexplored. The Hospital Frailty Risk Score (HFRS) stems from a list of ICD-10 CM codes which were found to be commonly associated in individuals with higher hospital use and resource utilization. The objective of this study is to evaluate the association between frailty scores and key clinical outcomes, including in-hospital mortality, length of stay (LOS), and total hospitalization costs (TOTCHG), among patients with cirrhosis using the Nationwide Inpatient Sample (NIS). Methods: A retrospective analysis of the NIS database from the years 2021 was conducted to identify adult patients with cirrhosis. Patients were stratified based on their frailty scores: low frailty (F1: < 5), intermediate frailty (F2: 5-15), and high frailty (F3: >15). Outcomes of interest included in-hospital mortality, complications (such as hepatic encephalopathy, variceal bleeding, and ascites), length of stay (LOS), and total hospitalization charges (TOTCHG). Multivariate logistic and linear regression analyses were performed, adjusting for relevant confounders using STATA software. Results: A total of 135,139 patients with cirrhosis were included. The in-hospital mortality rate was 1.47% for low frailty (F1), 8.88% for intermediate frailty (F2), and 17.04% for high frailty (F3). The adjusted odds ratio (aOR) for in-hospital mortality was 6.41 (95% CI: 5.44-7.56) for F2 and 13.40 (95% CI: 9.35-19.20) for F3 compared to F1. Additionally, patients with frailty scores of F2 and F3 had significantly increased risks of complications, including hepatic encephalopathy (F3: aOR 1.76, 95% CI: 1.33-2.33) and variceal bleeding (F3: aOR 0.44, 95% CI: 0.33-0.59). The mean length of stay (LOS) was 4.37 days for low frailty (F1), 8.42 days for intermediate frailty (F2), and 15.00 days for high frailty (F3) patients. Similarly, total hospitalization charges were $59,000 for low frailty (F1), $123,097 for intermediate frailty (F2), and $209,448 for high frailty (F3) patients. Discussion: Frailty is a significant predictor of adverse outcomes in hospitalized cirrhotic patients, including increased mortality, complications, length of stay, and healthcare costs. These findings underline the critical importance of incorporating frailty assessments into care for patients with cirrhosis to identify high-risk individuals and optimize resource allocation in healthcare.
Disclosures: Patel Manthanbhai indicated no relevant financial relationships. Eunice Kwak indicated no relevant financial relationships. Nahush Bansal indicated no relevant financial relationships. Hasan Al-Obaidi indicated no relevant financial relationships. Nooraldin Merza indicated no relevant financial relationships. Ali Nawras indicated no relevant financial relationships. Priyanaka Ahuja indicated no relevant financial relationships. Sudheer Dhoop indicated no relevant financial relationships. Muhammad Ali Ibrahim Kazi indicated no relevant financial relationships. Maram Albandak indicated no relevant financial relationships.
Patel Manthanbhai, MD1, Eunice Kwak, MD2, Nahush Bansal, MD3, Hasan Al-Obaidi, MD1, Nooraldin Merza, MD1, Ali Nawras, MD4, Priyanaka Ahuja, MD5, Sudheer Dhoop, MD6, Muhammad Ali Ibrahim Kazi, MD7, Maram Albandak, MD8. P5891 - Is Frailty a Predictor of Mortality, Complications, and Healthcare Utilization in Cirrhotic Patients? A Retrospective Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
