Effects of Liver Fibrosis on Physical Function and Readmission in Elderly Patients with Heart Failure

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Yoshifumi Abe, Yushi Shinohara, Hideki Tanaka, Yuta Saitoh
Purpose:

This study aimed to investigate these effects using the Fib-4 index.

Methods:

We retrospectively examined 328 patients aged 65 and older with heart failure (median age 80 years, 143 women) using the Fib-4 index. Patients were divided into two groups based on their Fib-4 index, with a cut-off value of 2.67. Physical function was assessed using the Short Physical Performance Battery at hospital discharge, with poor physical function defined as a score of ≤10 points. The association between the Fib-4 index and physical function was analyzed using a multivariable logistic regression model. Additionally, the prognostic value of the coexistence of a high Fib-4 index and poor physical function was investigated.

Results:

Of the 328 patients in this study, 172 (52%) were classified into the high Fib-4 index group, while 179 (55%) were in the poor physical function group. The median (25th, 75th percentile) Fib-4 index and Short Physical Performance Battery scores were 2.75 (2.03, 4.06) and 10 (7, 12), respectively. After adjusting for covariates, a high Fib-4 index was significantly associated with poor physical function (odds ratio: 1.15, 95% confidence interval: 1.01–1.31, p 0.05). Furthermore, the coexistence of a high Fib-4 index and poor physical function was associated with an increased risk of heart failure rehospitalization (hazard ratio: 1.86, 95% confidence interval: 1.11–3.30, p 0.05).

Conclusion(s):

Liver fibrosis is independently associated with poor physical function in patients with heart failure and increases their risk of readmission.

Implications:

When considering the readmission of elderly heart failure patients, not only physical function but also hepatic function status should be considered. This could assist in the development of tailored physiotherapy approaches.

Funding acknowledgements:
Tokyo Kasei University Organization for Research and Community Cooperation.
Keywords:
heart failure
liver fibrosis
physical function
Primary topic:
Cardiorespiratory
Second topic:
Non-communicable diseases (NCDs) and risk factors
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The study was approved by the Institutional Ethics Committee of Mitsui Memorial Hospital.
Provide the ethics approval number:
C31
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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