Dynamic changes in frailty and related factors in older patients with liver cancer: A latent transition analysis...

To dynamically identify latent classes and transition patterns of frailty from the preoperative to the postoperative period in older patients with liver cancer, and to determine the key influencing factors.

Between June 2024 and April 2025, a longitudinal study was conducted among 185 older patients with liver cancer at the Second Affiliated Hospital of Kunming Medical University in Yunnan Province. Data were collected using a general information questionnaire, the Fried Frailty Phenotype Scale, the Liver Frailty Index, the Liver Cancer Quality of Life Scale, and the Pittsburgh Sleep Quality Index. Latent class analysis identified frailty subgroups, and latent transition analysis (LTA) with a one-step approach examined dynamic transitions and covariates.

Two latent classes were identified across three time points (T0, T1, T2). The proportions of low-risk frailty were 65.95% (T0), 39.46% (T1), and 69.19% (T2); the proportions for high-risk frailty were 34.05% (T0), 60.54% (T1), and 30.81% (T2). From T0 to T1, 55% of the low-risk frailty transitioned to high-risk frailty, and 15.1% of the high-risk frailty transitioned to low-risk frailty. From T1 to T2, 16.4% of the low-risk frailty transitioned to high-risk frailty, and 67.3% of the high-risk frailty transitioned to low-risk frailty. A one-step LTA with covariates showed that unhealthy habits, disease duration, quality of life, sleep quality, and comorbidities were significant influencing factors.

Frailty in older patients with liver cancer is heterogeneous and follows a dynamic pattern of preoperative baseline, early postoperative crisis, and reversal during the recovery period. The influencing factors exhibited temporal specificity, indicating that nursing interventions should be both timely and targeted.