Falls are an underappreciated driver of morbidity and mortality in cirrhosis

Ha, Albert Y.; Saleh, Zachary M.; Serper, Marina; Tapper, Elliot B.

doi:10.1002/cld.1246

Cited by 6 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Falls are associated with declined PS, poor quality of life, and death in the elderly and patients with cirrhosis. In particular, the incidence of falls was 40% per year in those with minimal hepatic encephalopathy compared with 13% in those without 33 , 34 . In addition, fall trauma occurs in 54–74% and fractures in 6–12% of cases 35 – 37 .…”

Section: Discussionmentioning

confidence: 96%

Assessment of lower limb muscle strength can predict fall risk in patients with chronic liver disease

Takada,

Yamashita,

Osawa

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Falls are caused by a combination of factors, including loss of lower limb muscle strength (LMS), and associated with declined performance status (PS). Age-related sarcopenia is generally associated with decreased muscle mass and strength of lower limb muscle but without a noticeable loss of those of upper limb or trunk muscle. However, no reports have focused on falls or LMS in chronic liver disease (CLD) patients. This study is the first to analyze the risk factors for falls in patients with CLD, focusing on LMS measurement using the Locomoscan. This study enrolled 315 CLD patients whose LMS was measured. The patients who experienced falls more than 1 year ago or during the observation period were classified as those who experienced falls. We found that risk factors for falls were PS1/2 and decreased LMS (< 0.32 N/kg). The group with sarcopenia had a higher frequency of decreased LMS (54 vs. 26%, p = 0.001) and falls (24 vs. 4.4%, p < 0.001) compared to the non-sarcopenia group. This study found that decreased LMS was an independent risk factor for falls. Assessment of LMS may be used as a better marker associated with the risk of falls in patients with CLD.

show abstract

Section: Discussionmentioning

confidence: 96%

Assessment of lower limb muscle strength can predict fall risk in patients with chronic liver disease

Takada,

Yamashita,

Osawa

et al. 2024

Sci Rep

View full text Add to dashboard Cite

show abstract

“…In a general medical population, ischaemic heart disease, cancer, and COPD are likely to have the greatest impact on mortality;cirrhosis, mortality may be influenced more by kidney disease, infections, falls, delirium, and social determinants of health. 25 , [31] , [32] , [33] , [34] , [35] , [36] , [37] Compared with the other indices, HFRS is unique in its inclusion of social conditions, infections, falls/trauma, and dementia/delirium. Furthermore, although kidney disease and/or fluid and electrolyte disorders are present in all four indices, we note striking differences in their prevalence’s across the indices.…”

Section: Discussionmentioning

confidence: 99%

Hospital frailty risk score is superior to legacy comorbidity indices for risk adjustment of in-hospital cirrhosis cases

Desai,

Parvataneni,

Knapp

et al. 2024

JHEP Reports

View full text Add to dashboard Cite

“…In the short term, fall risk can be reduced through psychoactive medication stewardship, recognition of and timely therapy for HE, and deliberate but cautious patient mobilization. 13 - 15 In addition, a proactive approach to addressing malnutrition, frailty, and sarcopenia may reduce the risk of falls before and after liver transplantation. 16 Second, the case of a transfusion reaction with harm is instructive.…”

Section: Discussionmentioning

confidence: 99%

Medical malpractice claims in Hepatology: Rates, Reasons, and Results

Holman

McKeown

Quinn³

et al. 2023

Hepatology Communications

Self Cite

View full text Add to dashboard Cite

Background: Clinicians are motivated to provide safe, high-quality care to patients with chronic liver disease. This includes the desire to avoid litigation. Data are limited regarding the actual sources of medicolegal risk in chronic liver disease. Methods: We conducted a review of a national liability insurer (Candello) with an additional granular analysis of our institution’s registry of liability claims. We included closed cases involving chronic liver disease-related encounters between 2012 and 2021. We determined rates of legal claims from a denominator of unique patients with cirrhosis or transplant care seen over the study period. Results: Local database: We retrieved 39 claims of which 15 involved patients with non-cirrhotic chronic liver disease, 13 involved cirrhosis (0.06% incidence), and 11 involved patients who underwent transplantation (0.6% incidence). Most claims involved periprocedural complications. Others included adverse reactions to prophylactic plasma transfusion, medication-induced HE, and falls/fractures. National database: We found 94 claims related to liver disease out of 102,575 (0.09%) total claims. Overall, 56% involved diagnosis-related issues (failure/delay in ordering a diagnostic test, failure to appreciate and reconcile a symptom/sign or result, or the misinterpretation of a diagnostic study). Miscommunication between providers and between providers and patients was implicated in 22% of cases. Patient behavior-related factors (nonadherence with scheduled appointments, treatments, or diagnostic testing) factored in 20% of cases. Selection or the management of therapy played a role in 7% of cases. Very rarely were cases associated with technical skill (4%), house staff supervision (3%), or weekend/holiday care (1%). Fifty-one (55%) claims involved HCC. Conclusion: We provide the rates and reasons for medical malpractice claims in hepatology.

show abstract

Falls are an underappreciated driver of morbidity and mortality in cirrhosis

Cited by 6 publications

References 16 publications

Assessment of lower limb muscle strength can predict fall risk in patients with chronic liver disease

Assessment of lower limb muscle strength can predict fall risk in patients with chronic liver disease

Hospital frailty risk score is superior to legacy comorbidity indices for risk adjustment of in-hospital cirrhosis cases

Medical malpractice claims in Hepatology: Rates, Reasons, and Results

Contact Info

Product

Resources

About