HEALTH LITERACY AS A DETERMINANT OF FRAILTY IN PATIENTS WITH LIVER CIRRHOSIS

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.101980

Ismael de Jesús Yepes Barreto , Nicole Chamorro , Guillermo Donado

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引用次数: 0

Abstract

Introduction and Objectives

Health literacy (HL) is a key social determinant of health, especially in chronic conditions like cirrhosis, where disease management depends heavily on patient comprehension and engagement. HL refers to the ability to access, understand, and use health information to make informed decisions. Frailty, a state of decreased physiological reserve and increased vulnerability, is a strong predictor of adverse outcomes in cirrhosis. Although the Liver Frailty Index (LFI) is commonly used to assess physical frailty, the role of HL in this context remains poorly explored. This study aimed to determine the association between HL and frailty in patients with cirrhosis.

Patients and Methods

We conducted a cross-sectional study among adults with confirmed cirrhosis attending outpatient hepatology clinics in Cartagena, Colombia, between September and December 2024. HL was measured using the Short Assessment of Health Literacy for Spanish Adults (SAHL-S), and frailty was assessed with the LFI, which includes grip strength, chair stands, and balance tests. Trained clinicians performed all tests using calibrated equipment. Demographic and clinical variables were obtained from records and structured interviews. Patients with encephalopathy or severe mobility limitations were excluded. Frailty was defined as LFI ≥ 4.5.

Results

Among 89 participants (57.3% women, mean age 64.8), 85.4% were Child-Pugh A. History of decompensation and variceal bleeding were present in 24.7% and 13.5%, respectively. LFI categorized 15.7% as robust, 65.2% as prefrail, and 19.1% as frail. In multivariable analysis, low HL (OR 2.8; 95% CI 1.3–6.0) and variceal bleeding (OR 3.2; 95% CI 1.4–7.1) independently predicted frailty.

Conclusions

Low HL independently predicts frailty and should be addressed to improve outcomes in cirrhosis care.

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健康素养是肝硬化患者虚弱的决定因素

健康素养（HL）是健康的关键社会决定因素，特别是在肝硬化等慢性疾病中，疾病管理在很大程度上取决于患者的理解和参与。HL是指获取、理解和使用卫生信息以做出明智决策的能力。虚弱，一种生理储备减少和脆弱性增加的状态，是肝硬化不良结局的一个强有力的预测因子。尽管肝脆弱指数（LFI）通常用于评估身体虚弱，但HL在这方面的作用仍未得到充分探讨。本研究旨在确定HL与肝硬化患者虚弱之间的关系。患者和方法我们对2024年9月至12月在哥伦比亚卡塔赫纳肝病门诊就诊的确诊肝硬化成人进行了一项横断面研究。使用西班牙成人健康素养短期评估（SAHL-S）测量HL，使用LFI评估虚弱程度，其中包括握力、椅架和平衡测试。训练有素的临床医生使用校准的设备进行所有测试。从记录和结构化访谈中获得人口统计学和临床变量。排除有脑病或严重活动受限的患者。虚弱定义为LFI≥4.5。结果89名参与者中（57.3%为女性，平均年龄64.8岁），85.4%为Child-Pugh a。有失代偿史和静脉曲张出血分别占24.7%和13.5%。LFI将15.7%归类为健壮，65.2%为虚弱，19.1%为虚弱。在多变量分析中，低HL （OR 2.8; 95% CI 1.3-6.0）和静脉曲张出血（OR 3.2; 95% CI 1.4-7.1）独立预测虚弱。结论：slow HL独立预测衰弱，应加以解决，以改善肝硬化护理的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.