Body composition and short-term mortality in patients critically ill with acute-on-chronic liver failure

Rio, Thomas Mangana del; Sacleux, Sophie-Caroline; Vionnet, Julien; Ichaı̈, Philippe; Denys, Alban; Schneider, Antoine; Coilly, Audrey; Fraga, Montserrat; Wetze, Alexandre; Koerfer, Joachim; Chiche, Jean‐Daniel; Saliba, Faouzi; Moradpour, Darius; Becce, Fabio; Artru, Florent

doi:10.1016/j.jhepr.2023.100758

Cited by 7 publications

(4 citation statements)

References 51 publications

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“…Patients with ACLF are often found to have sarcopenia [17][18][19]. The SMI at the third lumbar vertebra (L3-SMI) re ects the skeletal muscle mass of the body and is also an important indicator for the diagnosis of sarcopenia [20][21].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Relationship between skeletal muscle index at the third lumbar vertebra with infection risk and long-term prognosis in patients with acute-on-chronic liver failure

Wang,

Bai,

Wang

et al. 2023

Preprint

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ObjectiveInfection is a major cause of increased mortality in patients with acute-on-chronic liver failure (ACLF). This study aims to examine the potential correlation of the skeletal muscle index at the third lumbar vertebra (L3-SMI) with infections among ACLF patients and to evaluate its impact on the long-term survival. MethodsThis retrospective study included 126 patients who underwent abdominal computed tomography (CT) and were diagnosed with ACLF at our center between December 2017 and December 2021. L3-SMI was calculated using CT, and the clinical and biochemical data as well as MELD scores were also collected, so as to analyze the relationship between L3-SMI and infections in ACLF patients and the impact on long-term prognosis. Results Of the 126 ACLF patients enrolled, 50 had infections. In the multivariate logistic regression analysis, both L3-SMI (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.81 - 0.97, P = 0.011) and hepatic encephalopathy (OR = 8.20, 95% CI= 1.70 - 39.59, P = 0.009) were independently associated with the risk of infection development. The overall survival (OS) estimates were obtained using Kaplan-Meier curves, and it was found that patients in the lowest tertile of L3-SMI had significantly lower 3-month, 6-month, 1-year, and 2-year survival rates than those in the highest tertile (P = 0.014; log-rank test). ConclusionsLow L3-SMI is an independent risk factor for the development of infections and significantly influences the long-term survival in ACLF patients.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Relationship between skeletal muscle index at the third lumbar vertebra with infection risk and long-term prognosis in patients with acute-on-chronic liver failure

Wang,

Bai,

Wang

et al. 2023

Preprint

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“…regarding the effects of sarcopenia in patients with ACLF. 42 However, the fact that our cohort was limited to patients on the WL for LT and considered LT as a competing risk for mortality may explain the differences in prognostic value.…”

Section: Discussionmentioning

confidence: 99%

Enhancing ACLF prediction by integrating sarcopenia assessment and frailty in liver transplant candidates on the waiting list

Perdiguero,

Spina,

Martínez

et al. 2024

JHEP Reports

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“…Hyperammonaemia also induces mitochondrial dysfunction and oxidative stress in muscle tissue 181 . Sarcopaenia results in frailty, which in turn is associated with higher mortality in patients with critical illness 182 …”

Section: Introductionmentioning

confidence: 99%

Review article: Evaluation and care of the critically ill patient with cirrhosis

Kosuta,

Premkumar,

Reddy

2024

Aliment Pharmacol Ther

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SummaryBackgroundThe increase in prevalence of liver disease globally will lead to a substantial incremental burden on intensive care requirements. While liver transplantation offers a potential life‐saving intervention, not all patients are eligible due to limitations such as organ availability, resource constraints, ongoing sepsis or multiple organ failures. Consequently, the focus of critical care of patients with advanced and decompensated cirrhosis turns to liver‐centric intensive care protocols, to mitigate the high mortality in such patients.AimProvide an updated and comprehensive understanding of cirrhosis management in critical care, and which includes emergency care, secondary organ failure management (mechanical ventilation, renal replacement therapy, haemodynamic support and intensive care nutrition), use of innovative liver support systems, infection control, liver transplantation and palliative and end‐of life care.MethodsWe conducted a structured bibliographic search on PubMed, sourcing articles published up to 31 March 2024, to cover topics addressed. We considered data from observational studies, recommendations of society guidelines, systematic reviews, and meta‐analyses, randomised controlled trials, and incorporated our clinical expertise in liver critical care.ResultsCritical care management of the patient with cirrhosis has evolved over time while mortality remains high despite aggressive management with liver transplantation serving as a crucial but not universally available resource.ConclusionsImplementation of organ support therapies, intensive care protocols, nutrition, palliative care and end‐of‐life discussions and decisions are an integral part of critical care of the patient with cirrhosis. A multi‐disciplinary approach towards critical care management is likely to yield better outcomes.

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Body composition and short-term mortality in patients critically ill with acute-on-chronic liver failure

Cited by 7 publications

References 51 publications

WITHDRAWN: Relationship between skeletal muscle index at the third lumbar vertebra with infection risk and long-term prognosis in patients with acute-on-chronic liver failure

WITHDRAWN: Relationship between skeletal muscle index at the third lumbar vertebra with infection risk and long-term prognosis in patients with acute-on-chronic liver failure

Enhancing ACLF prediction by integrating sarcopenia assessment and frailty in liver transplant candidates on the waiting list

Review article: Evaluation and care of the critically ill patient with cirrhosis

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