Annals of African Medicine · Nov 2, 2026
Assessment of Frailty and Its Association with the Severity of Liver Disease in Patients with Liver Cirrhosis
By Bhatt R, Kain R, Garg R et al.
Background: Frailty is an important predictor of outcomes in patients with liver cirrhosis, reflecting reduced physiological reserve and increased vulnerability. Traditional scoring systems such as the Child–Pugh Score and MELD-Na focus on biochemical parameters and may not fully capture functional decline. Aim: This study aimed to evaluate frailty alongside cirrhosis severity using objective tools. Materials and Methods: In this prospective study, 204 patients with cirrhosis were enrolled after ethics approval. Baseline investigations and etiological assessment were performed. Disease severity was assessed using Child–Pugh and MELD-Na scores, whereas frailty was evaluated using the liver frailty index (LFI) and short physical performance battery (SPPB). Multivariable regression analysis adjusted for age, sex, etiology, serum albumin, and renal function was performed, with P < 0.05 considered significant. Results: Frailty was highly prevalent, with alcohol as the leading etiology (44.6%). By LFI, 75.0% were frail, 24.5% pre-frail, and 0.5% robust; 54.9% had low SPPB scores. Frailty worsened with increasing Child–Pugh class, with mean LFI rising (4.25–5.22) and SPPB declining (8.57–5.66; P < 0.001). Child–Pugh score correlated positively with LFI ( r = 0.541) and negatively with SPPB ( r = −0.450). Similar trends were seen across MELD-Na categories. On multivariable analysis, LFI independently predicted worse disease severity (adjusted odds ratio [aOR] ≈6.0), whereas higher SPPB was protective (aOR ≈ 0.60; P < 0.001). Conclusion: Frailty is common in cirrhosis and can be reliably assessed using LFI and SPPB. Routine frailty assessment may improve risk stratification and guide management.