Índice de fragilidad hepática como predictor de rehospitalización temprana en pacientes cirróticos
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Rev. Cien. Tec. In.
Abstract
El índice de fragilidad hepática ha surgido como una herramienta valiosa para evaluar la disminución de la reserva fisiológica y la capacidad de recuperación funcional en pacientes con cirrosis hepática, una enfermedad crónica con alta carga de morbimortalidad que conlleva frecuentes episodios de descompensación y un elevado riesgo de hospitalización. Este estudio tuvo como finalidad determinar la utilidad de dicho índice como predictor de rehospitalización temprana. Se llevó a cabo una investigación observacional, descriptiva, longitudinal, prospectiva y analítica en el Instituto Gastroenterológico Boliviano Japonés, en Sucre, entre febrero y diciembre de 2023. Se evaluó a 39 pacientes con diagnóstico confirmado de cirrosis hepática durante las últimas 48 horas de hospitalización, con un seguimiento clínico de tres meses tras el alta. Se observó que el 69 % de los pacientes fueron rehospitalizados en ese periodo, y de ellos, el 77 % presentó un índice de fragilidad superior a 4,5. El análisis estadístico mostró una relación significativa entre un mayor índice y la probabilidad de rehospitalización, destacando un punto de corte superior a 4,8 como el más preciso para predecirla. Estos hallazgos respaldan el uso del índice de fragilidad hepática como una herramienta clínica eficaz para identificar a los pacientes con mayor riesgo de rehospitalización temprana, permitiendo así una intervención más oportuna y una mejor planificación del alta hospitalaria.
Abstract: The liver frailty index has emerged as a valuable tool for assessing the decline in physiological reserve and the ability to recover functional capacity in patients with liver cirrhosis, a chronic disease with a high burden of morbidity and mortality characterized by frequent decompensation episodes and a high risk of hospitalization. This study aimed to determine the usefulness of this index as a predictor of early rehospitalization. An observational, descriptive, longitudinal, prospective, and analytical study was conducted at the Bolivian Japanese Gastroenterology Institute in Sucre between February and December 2023. Thirty-nine patients with confirmed cirrhosis diagnosis were evaluated during the last 48 hours of hospitalization and followed clinically for three months after discharge. It was observed that 69% of patients were rehospitalized during this period, and of these, 77% had a liver frailty index greater than 4.5. Statistical analysis showed a significant relationship between a higher index and the probability of rehospitalization, with a cutoff point above 4.8 demonstrating the best discriminative ability to predict early readmission. These findings support the use of the liver frailty index as an effective clinical tool to identify cirrhotic patients at higher risk of early rehospitalization, allowing for more timely interventions and improved discharge planning.
Abstract: The liver frailty index has emerged as a valuable tool for assessing the decline in physiological reserve and the ability to recover functional capacity in patients with liver cirrhosis, a chronic disease with a high burden of morbidity and mortality characterized by frequent decompensation episodes and a high risk of hospitalization. This study aimed to determine the usefulness of this index as a predictor of early rehospitalization. An observational, descriptive, longitudinal, prospective, and analytical study was conducted at the Bolivian Japanese Gastroenterology Institute in Sucre between February and December 2023. Thirty-nine patients with confirmed cirrhosis diagnosis were evaluated during the last 48 hours of hospitalization and followed clinically for three months after discharge. It was observed that 69% of patients were rehospitalized during this period, and of these, 77% had a liver frailty index greater than 4.5. Statistical analysis showed a significant relationship between a higher index and the probability of rehospitalization, with a cutoff point above 4.8 demonstrating the best discriminative ability to predict early readmission. These findings support the use of the liver frailty index as an effective clinical tool to identify cirrhotic patients at higher risk of early rehospitalization, allowing for more timely interventions and improved discharge planning.
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Vol. 23, No. 34