Activity Measure for Post-Acute Care ‘6 clicks’ Short Forms (AM-PAC) and Model for End Stage Liver Disease score (MELD): A Retrospective Correlational Study in Patients with End Stage Liver Disease in Pre-Transplant Phase

Research Objectives: To Investigate the correlation of AMPAC and MELD scores in patients with ESLD in pre transplant phase.

Design: A single-center retrospective chart review was conducted on patients with diagnosis of ESLD and liver cirrhosis and the following identifiers were extracted: age, gender, BMI, MELD score, AM-PAC score from PT and OT consultation prior to transplant. All results were recorded in excel. BMI were calculated as they were not readily available in chart review. Body Mass Index (BMI) was calculated with the NIH standard Body Mass Index (BMI) online calculator based on the patient’s height (cm) and weight (kg). Patients who did not complete both OT and PT consultations with documented AM-PAC scores or does not have pre-operative diagnosis of ESLD and/or cirrhosis were excluded.

Setting: non-profit academic medical center

Participants: all adult patients admitted to the hospital with diagnosis of ESLD and liver cirrhosis on 1/1/2019 to 8/13/2021 but has not undergone liver transplant.

Interventions: Physical and occupational therapy interventions which includes bed mobility, transfer, balance and gait training, strengthening and ADLs self care training while in the hospital setting

Main Outcome Measures: Activity Measure for Post-Acute Care ‘6 clicks’ short forms (AM-PAC) and Model for End Stage Liver Disease score (MELD

Results: The relationship between MELD score and AMPAC scores were displayed in Figure 1. The scatter plot showed the higher the MELD score, the lower the AMPAC scores. The correlation was moderate in both physical therapy with rho = - 0.44 (p-value < 0.001) and occupational therapy with rho = - 0.43 (p-value < 0.001).

Conclusions: A negative correlation exists between AMPAC scores and MELD scores in pre-transplant patients with a diagnosis of ESLD and or liver cirrhosis. Therefore, the higher the MELD score the lower the AMPAC score is. Our findings support the use of both scoring system in pre-liver transplant patients in the inpatient hospital setting as a guide for safe activity and exercise prescription.

Author(s) Disclosures: no conflicts of interests that would give perception of bias.