The Comprehensive Frailty Severity Index (FSI) for End-Stage Liver Disease can be used to identify frailty in a patient undergoing liver transplant. This consists of multiple components, including physical performance and laboratory measures. The authors are from the University of Miami.
Patient selection: liver transplant recipient
Parameters for physical performance:
(1) Karnofsky performance status (KPS)
(2) decubitus ulcer stage
Parameters for laboratory testing:
(1) serum albumin in g/dL
(2) serum total cholesterol in mg/dL
(3) absolute lymphocyte count per microliter
Parameter
Finding
Points
KPS
80 to 100%
0
50 to 70%
2
10 to 40%
4
decubitus ulcer stage
none
0
Stage I or II
2
Stage III or IV
3
serum albumin
>= 3.5 g/dL
0
3.0 to 3.49 g/dL
2
2.5 to 2.99 g/dL
4
< 2.5 g/dL
6
serum total cholesterol
> 180 mg/dL
0
140 to 180 mg/dL
1
100 to 139 mg/dL
2
< 100 mg/dL
3
absolute lymphocyte count
> =1,600 per µL
0
1,200 to 1,599
1
800 to 1,199
2
< 800 per µL
3
subscore =
= SUM(points for all of these parameters)
Interpretation:
• minimum score: 0
• maximum score: 19
• The higher the score the greater the risk.
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