Background: We hypothesized that frailty acts as a measure of health outcomes in the context of LT. The aim of this study was to explore frailty index across LT, as a measure of morbidity and mortality. This was a retrospective observational study including all consecutive 47 HIV+patients who received LT in Modena, Italy from 2003 to June 2015. Methods: frailty index (FI) was constructed from 30 health variables. It was used both as a continuous score and as a categorical variable, defining 'most frail' a FI > 0.45. FI change across transplant (deltaFI, ÎFI) was calculated as the difference between year 1 FI (FI-Y1) and pre-transplant FI (FI-t0). The outcomes measures were mortality and "otpimal LT" (defined as being alive without multi-morbidity). Results: Median value of FI-t0 was 0.48 (IQR 0.42-0.52), FI-Y1 was 0.31 (IQR 0.26-0.41). At year five mortality rate was 45%, "optimal transplant" rate at year 1 was 38%. All the patients who died in the post-LT were most frail in the pre-LT. ÎFI was a predictor of mortality after correction for age and MELD (HR = 1.10, p = 0.006) and was inversely associated with optimal transplant after correction for age (HR = 1.04, p = 0.01). Conclusions: We validated FI as a valuable health measure in HIV transplant. In particular, we found a relevant correlation between FI strata at baseline and mortality and a statistically significant correlation between, ÎFI and survival rate.
A frailty index predicts post-liver transplant morbidity and mortality in HIV-positive patients / Guaraldi, Giovanni; Dolci, Giovanni; Zona, Stefano; Tarantino, Giuseppe; Serra, Valentina; Ballarin, Roberto; Franceschini, Erica; Codeluppi, Mauro; Brothers, Thomas D.; Mussini, Cristina; DI BENEDETTO, Fabrizio. - In: AIDS RESEARCH AND THERAPY. - ISSN 1742-6405. - 14:1(2017), pp. 37-45. [10.1186/s12981-017-0163-x]
Data di pubblicazione: | 2017 | |
Titolo: | A frailty index predicts post-liver transplant morbidity and mortality in HIV-positive patients | |
Autore/i: | Guaraldi, Giovanni; Dolci, Giovanni; Zona, Stefano; Tarantino, Giuseppe; Serra, Valentina; Ballarin, Roberto; Franceschini, Erica; Codeluppi, Mauro; Brothers, Thomas D.; Mussini, Cristina; DI BENEDETTO, Fabrizio | |
Autore/i UNIMORE: | ||
Digital Object Identifier (DOI): | http://dx.doi.org/10.1186/s12981-017-0163-x | |
Rivista: | ||
Volume: | 14 | |
Fascicolo: | 1 | |
Pagina iniziale: | 37 | |
Pagina finale: | 45 | |
Codice identificativo ISI: | WOS:000406943000001 | |
Codice identificativo Scopus: | 2-s2.0-85026835013 | |
Codice identificativo Pubmed: | 28779758 | |
Citazione: | A frailty index predicts post-liver transplant morbidity and mortality in HIV-positive patients / Guaraldi, Giovanni; Dolci, Giovanni; Zona, Stefano; Tarantino, Giuseppe; Serra, Valentina; Ballarin, Roberto; Franceschini, Erica; Codeluppi, Mauro; Brothers, Thomas D.; Mussini, Cristina; DI BENEDETTO, Fabrizio. - In: AIDS RESEARCH AND THERAPY. - ISSN 1742-6405. - 14:1(2017), pp. 37-45. [10.1186/s12981-017-0163-x] | |
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2017_ A frailty index predicts.pdf | Versione dell'editore (versione pubblicata) | Open Access Visualizza/Apri |
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