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Published on: June 8, 2017
Objective Versus Subjective Assessment of Functional Status in Candidates for Liver Transplantation
1Midwestern University Arizona College of Osteopathic Medicine, Glendale, AZ.
Introduction:
and aim. Poor functional status is associated with increased mortality in cirrhosis patients awaiting liver transplantation (LT); however, the optimal assessment of functional status remains unknown. This study sought to determine the relationship between 6-minute walk distance (6MWD) and Karnofsky Performance Status (KPS) and their association with waitlist mortality in LT candidates.
Material And Methods:
Two hundred seventy-eight consecutive patients listed for LT were included. KPS and 6MWD were assessed at the time of evaluation. KPS was recorded as a percentage from 0 to 100, with 0 representing death and 100 representing no presence of disease. Patients were followed from time of listing until transplantation, death, removal from the waitlist or end of the study period.
Results:
The mean KPS and 6MWD were 77.4 ± 13.5 and 323.6 ± 163.9 m, respectively. A mild correlation between 6MWD and KPS was demonstrated (Spearman ρ = 0.4317, P < .0001). KPS was significantly lower in patients with 6MWD < 250 meters (P < .0001). The 6MWD was significantly lower in patients who suffered waitlist mortality (266.1 vs 331.8 m, P = .05).
Conclusion:
In conclusion, 6MWD is a better predictor of waitlist mortality than KPS score in candidates for LT. The addition of 6MWD as a standard assessment may help to identify patients at risk of dying on the waitlist.
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