Frailty After Transarterial Chemoembolization for Hepatocellular Carcinoma: A Cross-Sectional Study of Incidence and Associated Factors

OBJECTIVE: To evaluate the incidence of and factors associated with frailty in hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE), with the objective to inform future personalized managements. METHODS: In this cross-sectional study conducted from January to October 2025, HCC patients undergoing TACE at a tertiary hospital in Suzhou were selected by convenience sampling and completed a general information questionnaire. The Fried frailty phenotype, Nutritional Risk Screening 2002 tool, and Barthel Index for activities of daily living were comprehensively evaluated between postoperative days 1 and 4 following TACE. Factors associated with frailty after TACE were identified via univariate and multivariate logistic regression analyses. RESULTS: Among the 312 included patients, 87 (27.9%) patients and 225 (72.1%) patients were in the frailty and non-frailty groups, respectively. Univariate analysis revealed statistically significant differences in age, sex, nutritional risk, Barthel Index, systemic immune-inflammatory index (SII), and hemoglobin level between the two groups (P<0.05). Multivariate logistic regression analysis identified that age, sex, nutritional risk, Barthel Index, SII, and hemoglobin level were associated with frailty after TACE, with odds ratios of 1.060, 4.199, 6.870, 0.954, 1.001, and 0.980, respectively (all P<0.05). CONCLUSION: A significant number of HCC patients could have frailty after TACE. Advanced age, female sex, poor nutrition, low Barthel Index, high SII, and low hemoglobin level were associated with frailty in these patients. Further prospective trials are required to identify modifiable variables and evaluate interventions to prevent or reduce frailty in HCC patients undergoing TACE.