Low Daily Step Count Is Associated With a High Risk of Hospital Admission and Death in Community-Dwelling Patients With Cirrhosis

Daily step count measures cardiorespiratory fitness and has been associated with clinical outcomes. However, its utility in patients with cirrhosis remains largely unexplored. We aimed to investigate the association between step count, frailty metrics, and clinical outcomes in cirrhosis. All partici...

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Published in:	Clinical gastroenterology and hepatology 2022-08, Vol.20 (8), p.1813-1820.e2
Main Authors:	Lin, Fei-Pi, Bloomer, Pamela M., Grubbs, Rachel K., Rockette-Wagner, Bonny, Tevar, Amit D., Dunn, Michael A., Duarte-Rojo, Andres
Format:	Article
Language:	eng
Subjects:	Aged End Stage Liver Disease Fibrosis Frailty Hospitals Humans Independent Living Liver Cirrhosis Male Middle Aged Personal Activity Tracker Severity of Illness Index Sodium Wearables
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Summary:	Daily step count measures cardiorespiratory fitness and has been associated with clinical outcomes. However, its utility in patients with cirrhosis remains largely unexplored. We aimed to investigate the association between step count, frailty metrics, and clinical outcomes in cirrhosis. All participants underwent frailty evaluation with the liver frailty index, 6-minute walk test, and gait speed test. To monitor step count, participants were given a personal activity tracker (PAT). A subset also was invited to use Exercise and Liver FITness (EL-FIT). Daily step counts from the first week of PAT use and frailty metrics were investigated as predictors of hospital admission and mortality. There were 116 patients included (age, 56 ± 11 y; male, 55%; body mass index, 31 ± 7; model for end-stage liver disease-sodium, 15 ± 7). The main etiologies of cirrhosis were alcohol-related (33%) and nonalcoholic steatohepatitis (30%). Monitoring for the week was accomplished in 80% of participants given both PAT+EL-FIT vs 62% in those with PAT only (P = .04). During follow-up evaluation, hospital admission was observed in 55% and death in 15%. Kaplan–Meir curves showed increased readmission and deaths among patients performing in the lowest quartile (ie,
ISSN:	1542-3565 1542-7714