IMPACT OF FRAILTY ON PHYSICAL ACTIVITY IN THE POST-OPERATIVE PERIOD AFTER LIVER TRANSPLANT SURGERY; PILOT STUDY USING FITBIT WATCH

Document Type

Conference Proceeding

Publication Date

10-1-2022

Publication Title

Hepatology

Abstract

Background: Several studies highlight the negative impact of physical frailty on waitlist mortality and post-transplant outcomes for liver transplant (LT) recipients. Although pre-and post-transplant physical activity are important determinants of long-term health after LT, patient's and provider physical activity assessments do not reliably indicate actual performance. This pilot study aimed to evaluate the utility of a PAM in tracking postoperative biophysical data after LT and the impact of pre-transplant frailty on post-operative physical activity. Methods: 49 adult LT candidates were enrolled in the study between February 2021 and February 2022 after being screened for inclusion. LT candidates were excluded if they were undergoing multi-organ transplant, were intubated, or had severe hepatic encephalopathy prior to transplant. Liver Frailty Index (LFI) was performed pre-transplant and on post-operative days (POD) 30 and 60. All patients were provided with a Fitbit® Inspire 2 watch and were instructed to wear it continuously for the duration of the study. Biophysical data including daily steps and exercise intensity duration/ distance was collected using the Fitbit® Inspire 2 watch. Results: 35 patients with complete frailty and PAM data were included in the final cohort. The average daily steps during the first 30 days after LT correlated negatively with increasing age (r -0.52, p=0.001) and longer hospital length of stay (r -0.43, p=0.01). According to pre-transplant LFI, the patients were categorized into: Frail (n=15, 43%) and non-frail (n=21, 57%). Baseline characteristics between both groups were similar except for increased proportion of encephalopathy in frail patients compared to non-frail patients (86% vs. 38% respectively; p=0.005). Based on pre-LT LFI, 'frail' patients' had lower mean daily steps during the first 30 days after LT compared to 'non-frail' patients (steps [SD]: 3045 [2156] vs. 1557 [1269] respectively; p=0.02) [Figure 1A]. According to POD 30 LFI: 'frail' patients had lower mean daily steps during POD 31-60 compared to 'non-frail' patients (steps [SD]: 5563 [2935] vs. 2975 [2733] respectively; p=0.02) [Figure 1B]. Conclusion: This study demonstrated the usefulness of a PAM for tracking patient's physical activity after LT. Understanding the impact of pre-transplant frailty can lead to individualized post-operative interventions for 'frail' patients after LT to improve physical activity, decrease sedentary time, and lead to better postoperative healing.

Volume

76

First Page

S458

Last Page

S459

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