The influence of prehabilitation in patients with liver cirrhosis before liver transplantation: a randomized clinical trial.
Ľubomír Skladaný, Dávid Líška, Daniel Gurín and 4 others
PMID 38059578WHAT IT FOUND
Prehabilitation improved liver frailty and Child-Pugh scores after one month, but very low patient adherence prevented any conclusions at three months.
The study could not determine if prehabilitation is more effective than standard care for patients awaiting liver transplantation.
Key findings
01The liver frailty index improved in the prehabilitation group after one month, but no differences were found between groups at that time point.
02The Child-Pugh score showed better clinical outcomes in the prehabilitation group compared with standard care after one month.
03Adherence dropped drastically by three months, with only nine patients total attending follow-up, making long-term comparison impossible.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Very low adherence at three months meant only nine of eighty patients were available for long-term analysis, making it impossible to draw conclusions about sustained effectiveness. The study was single-center, which limits generalizability. The primary outcome was not explicitly defined as a single endpoint, but the authors conclude they cannot determine effectiveness due to the adherence issues. Baseline severity differed between groups, with the standard care group having a higher MELD score (18.83 vs 15.78), which may have influenced outcomes.
Declared interests
The authors declared no conflicts of interest. The study was funded by an internal grant from the Slovak Medical University.
The easy way to misread this
Do not interpret the short-term improvements in frailty and Child-Pugh scores as proof that prehabilitation is superior to standard care. The study explicitly states that no conclusion about effectiveness can be drawn because adherence was too low to compare groups at three months, and even at one month, the between-group difference for frailty was not significant.