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A Review on Frailty in Patient with Liver Cirrhosis and Its Management

Thasneem S, Yedu Krishnan SS, Roshni PR, Shine Sadasivan

Frailty is an unstable phenomenon affecting multiple physiological systems, resulting in decreased reserve and vulnerable outcomes. With ageing the prevalence of frailty seems to be increasing general population as well as with cirrhosis patients. Though research are undergoing on prognostic markers, gut microbes or pharmacology in hepatology, it should be extended to a proper definition for frailty its diagnostic tool and management. Frailty score should be considered along with MELD score as a routine assessment in patients waiting for liver transplantation. Malnutrition is a common complication of cirrhosis patients which may leads to frailty, even though frailty is seen in well-nourished patients. When normal dietary supplements become ineffective the need for nutritional supplements like Branched chain amino acids (BCAA) become necessary. Combining BCAAs along with exercise therapy have shown significant improvements for lower limb muscle strength and balance ability in frail and pre-frail cirrhotic patients since muscle wasting is a major concern for them.