Psychological contributors to the frail phenotype: The association between resilience and frailty in patients with cirrhosis.
Psychological contributors to the frail phenotype: The association between resilience and frailty in patients with cirrhosis.
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DOI：
10.1111/ajt.16131
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Lai JC
中科院分区：
文献类型：
--
作者：
Wong RJ;Mohamad Y;Srisengfa YT;Kent DS;Seetharaman S;Shah RJ;Lai JC
我们研究了一个关键的心理特征--弹性，定义为一个人从困难中快速恢复的能力--是否有助于肝硬化患者的虚弱表型。纳入了300例肝硬化成人患者，他们接受了使用肝虚弱指数进行的门诊身体虚弱测试和使用Connor-Davidson弹性量表（CD-RISC）进行的弹性测试。肝虚弱指数被分类为强健、虚弱前强健、虚弱前虚弱和虚弱; CD-RISC使用人群标准被分类为：最小、更小、更大和最有弹性。使用线性回归评估与虚弱相关的因素（通过肝虚弱指数每0.1单位变化）。在最有弹性的人中，只有10%的人身体虚弱;在最没有弹性的人中，29%的人身体虚弱。在单变量分析中，恢复力与肝虚弱指数密切相关（coef=-0.13/点增加; 95%CI，-0.20--0.60; p<0.001），在多变量调整中与虚弱保持显著相关（coef=-0.13，95%CI-0.19--0.07; p<0.001）。低弹性与肝硬化患者的虚弱表型密切相关。鉴于弹性是可以改变的，我们的数据表明，有效的干预措施，以减轻脆弱性应包括战略，建立弹性低基线弹性患者的弹性。
We examined whether a key psychological trait—resilience, defined as one’s ability to recover quickly from difficulties—contributes to the frail phenotype in patients with cirrhosis. Included were 300 adult patients with cirrhosis who underwent outpatient physical frailty testing using the Liver Frailty Index and resilience testing using the Connor-Davidson Resilience Scale (CD-RISC). The Liver Frailty Index was categorized as robust, prefrail-robust, prefrail-frail, and frail; CD-RISC was categorized using population norms as: least, less, more, and most resilient. Linear regression was used to assess factors associated with frailty (by the Liver Frailty Index per 0.1 unit change). Among the most resilient, only 10% were frail; among the least resilient, 29% were frail. In univariable analysis, resilience was strongly associated with the Liver Frailty Index (coef=−0.13 per point increase; 95% CI, −0.20–−0.60; p<0.001) and remained significantly associated with frailty in multivariable adjustment (coef= −0.13, 95% CI −0.19– −0.07; p<0.001). Low resilience is strongly associated with the frail phenotype in patients with cirrhosis. Given that resilience is modifiable, our data suggest that effective interventions to mitigate frailty should include strategies to build resilience in patients with low baseline resilience.
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