The purpose of this study was to determine the factors that influence the achievement of independent ambulation at the end of physical therapy in patients after LDLT.
This retrospective cohort study involved 60 patients who had undergone LDLT for severe hepatic dysfunction (Child-Pugh class C) in the Department of Transplant Surgery of our hospital between January 2010 and December 2022 and received physiotherapy during hospital admission. To identify factors associated with independent walking, we classified patients based on their ability to walk independently. Patients were classified into 2 groups according to their walking ability at the end of physiotherapy using the mobility FIM score, with a cutoff value ≥6 points indicating the achievement of independent walking irrespective of walking speed. We performed multiple logistic regression analyses with the patients’ attributes, biochemical tests, and physical function, considering the achievement or non-achievement of independent walking as dependent variables, and factors that were significantly different between the 2 groups in the univariate analysis (P .05) as independent variables, after adjusting for age, sex, and body mass index. Moreover, we calculated cutoff values from the receiver operating characteristic (ROC) curves.
There were 25 male and 35 female patients with a mean age of 51.2 ± 11.6 years. The independent walking group included 53 patients, and the No independent walking group included 7 patients. All patients were Child-Pugh class C and suffered from severe hepatic dysfunction. A comparison between groups showed significant differences in aspartate aminotransferase (AST) at the end of physiotherapy, CRP at the end of physiotherapy, Patient Outcome . The factor associated with achieving independent walking at the end of physiotherapy (on discharge) was AST value at the end of physical therapy (odds ratio = 0.96, P .05), and its cutoff value, calculated from the ROC curves curve, was 33.5(U/L), with an area under the curve of 0.57 and 57.1% sensitivity and 41.5% specificity .
AST value at the end of physical therapy may be related to the acquisition of independent walking. Although no previous studies clarifying the relationship between Independent walking and AST levels were found as far as we hunted. However, liver dysfunction Has been reported to be a risk factor for the need for nursing care in the elderly. AST value is a reliable indicator of independent walking after LDLT.
By clarifying the relationship between the acquisition of independent walking and liver function, it was shown that AST value is a reliable indicator of independent walking after LDLT.
Independent walking
AST
