Frailty: a predictor of mortality, hospital readmission, and length of stay?

The Hospital Frailty Risk Score (HFRS) was developed to detect frail individuals based on data extracted from hospital databases. An association between the HFRS, 30-day mortality, 30-day emergency hospital readmission, and long length of stay (LOS) was originally validated in populations of elderly patients admitted to hospital via the emergency department. Data regarding the HFRS’ predictive ability in the context of direct admissions and post-discharge outcomes is thus lacking.

The aim of this study was to investigate the associations between the HFRS and 30-day mortality, 30-day hospital readmission, and long LOS by analysing in- and out-patient healthcare in France.

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Muscle mass, hepatocellular carcinoma and liver transplantations: a review

For hepatocellular carcinoma, the most common type of liver cancer, liver transplantations are considered the best treatment, as they present with a 60-80% survival rate for 5 years. Suitability for a transplant is assessed by factors such as the patient’s tumour presentation and their responses to treatments, with the Milan Criteria representing the total criteria with all additional prognostic factors. Yet, general health is rarely included into this judgement. General health, especially low muscle pass (e.g, sarcopenia) may affect survival rates for liver transplantations; this has, however, rarely been addressed. This study discovered that a higher pre-operative muscle mass contributed to an increased rate of long-term survival post-liver transplantation.
This review by Beumer B et al. aimed to determine whether adding in the consideration of muscle mass, and working beyond the Milan Criteria, may benefit our understanding of the outcomes of liver transplantations.

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Weight loss as a precursor to cancer diagnosis: a review

Weight loss is clearly related to cancer, yet there is very little data concerning when and at what stage weight loss should be considered a sign of a need to diagnose cancer. In this study of 43,302 patients, it was found that there was a linear increase in the chance of being diagnosed with cancer compared to the amount of weight lost. This finding was independent of any co-factors, such as age, sex, original weight or co-morbidities. Therefore, it is clear that the percentage of weight lost must be focused on, rather than a guideline with an arbitrary cut-off point for a cancer diagnosis. It could be possible to trigger an alert for patients who lose certain percentages of weight over specified periods of time.
This review by Nicholson B et al aimed to understand the diagnostic value of weight loss in relationship to cancer.

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Targeting oxidative stress in cancer- and chemotherapy-induced muscle wasting: a review

Cancer is often associated with cachexia, a wasting syndrome which is multifactorial and cannot be resolved with simple nutritional aid. It causes loss of muscle mass and is the cause of death for almost a third of cancer patients. However, cachexia is very complex. This muscle-wasting disorder has many underlying mechanisms, whether cancer-induced or chemotherapy induced. Heighted protein catabolism and reduced anabolism, as well as disrupted energy metabolism, are associated with cachexia, but the mechanisms underlying these changes are not fully known. Inflammation and oxidative stress are believed to be important within the mechanisms.
This review by Huot J et al. aimed to evaluate the mechanisms underlying cancer cachexia, particularly discussing the role of oxidative stress.

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Experience of renal cachexia in end-stage renal disease and the interrelated experience of their carers: a review

Renal cachexia often occurs in end-stage renal disease, yet there are few guidelines for clinicians in how to treat and manage this condition. To ensure a patient-centric approach, understanding the experiences of patients with renal cachexia, as well as their carers, will help to implement the most beneficial guidelines possible. This study focuses on assessing quality of life outcomes, including psychological and social factors, in an attempt to raise awareness about the impact of cancer cachexia. This information aims to inform the management of renal cachexia, as well as general holistic care within the field of nephrology.
This review by Blair C et al. aimed to synthesize the lived experiences of renal cachexia in patients suffering with end-stage renal disease, as well as that of their carers.

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Frailty: a growing concern in the UK

Frailty is characterised by increased vulnerability to acute stressors associated with an age-related decline in function across multiple physiological systems. Since it is an age-dependent clinical syndrome, countries with ageing populations, like the United Kingdom (UK), are predicted to become increasingly exposed to worsening frailty-associated patient outcomes and burdened healthcare systems.

This article aimed to emphasise the importance of frailty-related education for healthcare professionals in the UK.

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