Liver Frailty Index

  • Administration time: 5 minutes
  • Requires physical performance test
  • Predicts mortality in patients with end-stage liver disease

1. Gender

2. Dominant hand grip strength

3. Time to complete 5 chair stands

If patient is unable to complete all 5 chair stands in 60 seconds, enter 0 for the time.

4. Balance

For each position, stop at 10 seconds or the time to one decimal point that the patient steps out of the position. If the position is held for 10 seconds or more, record 10 seconds.

Key references

  • Lai JC, Covinsky KE, Dodge JL, Boscardin WJ, Segev DL, Roberts JP, Feng S. Development of a novel frailty index to predict mortality in patients with end-stage liver disease. Hepatology. 2017 Aug;66(2):564-574. doi: 10.1002/hep.29219. Epub 2017 Jun 28. PMID: 28422306; PMCID: PMC5519430.
  • Wang CW, Lebsack A, Chau S, Lai JC. The Range and Reproducibility of the Liver Frailty Index. Liver Transpl. 2019 Jun;25(6):841-847. doi: 10.1002/lt.25449. Epub 2019 Apr 29. PMID: 30884128; PMCID: PMC6542696.
  • Haugen CE, McAdams-DeMarco M, Verna EC, Rahimi RS, Kappus MR, Dunn MA, Volk ML, Gurakar A, Duarte-Rojo A, Ganger DR, O'Leary JG, Ladner D, Garonzik-Wang J, Segev DL, Lai JC. Association Between Liver Transplant Wait-list Mortality and Frailty Based on Body Mass Index. JAMA Surg. 2019 Dec 1;154(12):1103-1109. doi: 10.1001/jamasurg.2019.2845. Erratum in: JAMA Surg. 2019 Oct 23;: PMID: 31509169; PMCID: PMC6739734.
  • Liver Frailty Index™ available at:

Alternative tools to Liver Frailty Index

Risk Analysis Index