Home exercise, branched-chain amino acids, and probiotics improve frailty in cirrhosis : A randomized clinical trial
Roman, Eva (Institut de Recerca Sant Pau)
Kaur Gill, Naujot (Institut de Recerca Sant Pau)
Sánchez, Elisabet (Institut de Recerca Sant Pau)
Poca Sans, Maria (Institut de Recerca Sant Pau)
Padros i Valls, Josep (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Nadal, Mª Josepa (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Cuyàs, Berta (Institut de Recerca Sant Pau)
Alvarado-Tapias, Edilmar (Institut de Recerca Sant Pau)
Vidal, Silvia (Institut de Recerca Sant Pau)
Ortiz, M. Àngels (Institut de Recerca Sant Pau)
Hernández Martínez-Esparza, E. (Institut de Recerca Sant Pau)
Santesmases Masana, Rosalia (Universitat Autònoma de Barcelona)
Urgell, Eulàlia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Juanes Borego, Elena (Institut de Recerca Sant Pau)
Ferrero-Gregori, Andreu (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Escorsell, Àngels (Institut de Recerca Sant Pau)
Guarner, Carlos (Institut de Recerca Sant Pau)
Soriano, German (Institut de Recerca Sant Pau)

Data:	2024
Resum:	Frailty is a predictive factor of hospitalization, falls, and mortality in patients with cirrhosis, regardless of the degree of liver failure. The aim was to analyze whether a multifactorial intervention consisting of home-based exercise, branched-chain amino acids, and a multistrain probiotic can improve frailty in these patients. Outpatients with cirrhosis were classified according to the Liver Frailty Index (LFI). Prefrail and frail patients were randomized into 2 groups. The intervention group was assigned to a multifactorial intervention consisting of exercise at home, branched-chain amino acid supplements, and a multistrain probiotic for 12 months. The control group received standard care. All patients were prospectively followed up every 3 months for 1 year to determine LFI, incidence of falls, emergency room visits, hospitalizations, and mortality. Thirty-two patients were included: 17 patients were assigned to the intervention group and 15 to the control group. In the intervention group, the baseline LFI decreased at 3, 6, 9, and 12 months (p = 0. 019 for overall change with respect to the control group). The change in LFI (ΔLFI) at 12 months was -0. 71 ± 0. 24 in the intervention group and -0. 09 ± 0. 32 in the control group (p<0. 001). During follow-up, patients in the intervention group had a lower 1-year probability of falls (6% vs. 47%, p = 0. 03) and emergency room visits (10% vs. 44%, p = 0. 04) than patients in the control group. A long-term multifactorial intervention that included exercise at home, branched-chain amino acids, and a multistrain probiotic improved frailty in outpatients with cirrhosis and was associated with a decrease in the incidence of clinical events such as falls and emergency room visits. 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.
Ajuts:	Instituto de Salud Carlos III PI19/00275
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Hepatology Communications, Vol. 8 Núm. 5 (march 2024) , p. 10.1097/HC9.0000000000000443, ISSN 2471-254X

DOI: 10.1097/HC9.0000000000000443
PMID: 38701490

13 p, 1.0 MB

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