Frailty Predicts Outcomes and Prognosis of Liver Cirrhosis Patients: A Meta-Analysis and Systematic Review

Studies have assessed the role of frailty in estimating the prognosis of liver cirrhosis patients; however, conflicting findings were found across the reports. The focus of this study was to look into the relationship between frailty and the prognosis of patients with liver cirrhosis. We performed a meta-analysis between August 2020 and January 2021. Data were obtained from articles present in the Web of Science, Embase, and PubMed. The comparison between frailty and the outcomes [ascites, hepatic encephalopathy, mortality, and the model for end-stage liver disease (MELD) score] among liver cirrhosis patients was calculated using a Z test. We included 1,318 liver cirrhosis patients with frailty and 3,579 patients without frailty, retrieved from 9 papers. Frail patients used to have a 1.5-fold and 1.94-fold greater chance of developing ascites [relative risk (RR): 1.65; 95% confidence interval (CI): 1.29, 2.13] and hepatic encephalopathy (RR: 1.94; 95% CI: 1.39, 2.70), respectively, compared with patients without frailty among liver cirrhosis patients. We also revealed that liver cirrhosis patients with frailty had higher odds of mortality than patients without frailty (RR: 2.10; 95% CI: 1.33, 3.34). Furthermore, a higher MELD score was noted in liver cirrhosis patients with frailty than in patients without frailty (mean difference: 2.07; 95% CI: 1.08, 3.07). Frailty is an important predictor of ascites, hepatic encephalopathy, mortality, and a higher MELD score among liver cirrhosis patients.