Does Physical Frailty and Pulmonary Function Affect the Number of Hospital Stay Among Liver Cirrhosis Patients? - A Retrospective Study

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Background and need of research: Cirrhosis is permanent scarring(fibrosis) of liver and its major complication is frailty, defined as deterioration in physical and physiological function. Other complications such as Ascites, Hepatopulmonary syndrome, Respiratory muscles and generalized muscle weakness cause alteration in pulmonary function which is associated with frequent hospitalization and delisting from transplantation. The main aim of this study is to evaluate physical frailty and degree of pulmonary function abnormalities among cirrhotic patient using Short physical performance battery (SPPB) and pulmonary function using forced based spirometry pulmonary test (PFT) and to determine its relation with hospitalizations in cirrhotics. Methods: After approval from the institutional ethical committee, data of one hundred and thirty-three liver cirrhotic patients were retrieved from Physiotherapy department and Abdominal Organ Transplant between January’22-November’22. Data available like demographic and clinical parameters, severity of frailty assessed by Short Physical Performance Battery (SPPB) and Pulmonary Function Test (PFT) were evaluated. Statistical analysis was done using SPSS V.25(IBM). Result: Out of 133 subjects, 18(8%), 8(21%), 52(39%) were severely, moderate, and mildly frail respectively. In PFT findings, 15(11%), 43(32%), 16 (12%) had mild, moderate, and severe restriction. 4-meter gait speed test was weakly correlated with number of hospital admissions (r=0.199, p<0.05). Sit to Stand test (STS) was moderately correlated with number of hospital admissions (r=0.24, p<0.05). Comparison with categories of PFT and hospital admissions was not significant (Kruskal-Walli’s test, p<0.53). Conclusion and Clinical Implications: SPPB (4m gait speed and Chair STS test) showed weak correlation with number of hospitalizations. However, PFT showed no correlation with number of hospitalizations. Findings of this study imply that assessment of frailty can be used to guide future rehabilitation for such patients. Keywords: Short Physical Performance Battery, Liver cirrhosis, Pulmonary function Test, Frailty, Retrospective study.