Sarcopenia as a Useful Predictor for Long-Term Mortality in Cirrhotic Patients with Ascites

Abstract

This study aimed to assess and compare sarcopenia with other prognostic factors for predicting long-term mortality in cirrhotic patients with ascites. Clinical data of 65 among 89 patients with measurement of all parameters were consecutively collected. Sarcopenia was evaluated as right psoas muscle thickness measurement divided by height (PMTH) (mm/m). During a mean follow-up of 20 (range: 1-49) months, 19 (29.2%) of 65 patients died. The values of the area under the receiver operating characteristics curve (AUROC) of Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, MELD-Na, and PMTH for predicting 1-yr mortality were 0.777 (95% CI, 0.635-0.883), 0.769 (95% CI, 0.627-0.877), 0.800 (95% CI, 0.661-0.900), and 0.833 (95% CI, 0.699-0.924), whereas hepatic venous pressure gradient was not significant (AUROC, 0.695; 95% CI. 0.547-0.818, P=0.053). The differences between PMTH and other prognostic variables were not significant (all P>0.05). The best cut-off value of PMTH to predict long-term mortality was 14 mm/m. The mortality rates at 1-yr and 2-yr with PMTH>14 mm/m vs. PMTH≤14 mm/m were 2.6% and 15.2% vs. 41.6% and 66.8%, respectively (P<0.001). The mortality in cirrhotic patients with PMTH≤14 mm/m was higher than those with PMTH>14 mm/m (HR, 5.398; 95% CI, 2.111-13.800, P<0.001). In conclusion, sarcopenia, evaluated by PMTH, is an independent useful predictor for long-term mortality in cirrhotic patients with ascites.Graphical Abstract

Growth of ovarian cancer xenografts causes loss of muscle and bone mass: a new model for the study of cancer cachexia

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Development of a simple predictive model for decreased skeletal muscle mass in patients with compensated chronic liver disease

“…There are currently no established practice guidelines for clinicians pertaining to treatment or management of sarcopenic patients . Sarcopenia is generally diagnosed using techniques such as hand grip strength analysis, gait speed analysis, computed tomography (CT), dual energy X‐ray absorptiometry, and bioimpedance analysis (BIA) . Although hand grip strength and gait speed analyses can be carried out in low‐resource settings, poor reproducibility and accuracy limit their diagnostic utility.…”

Quantification of Adipose Tissue and Muscle Mass Based on Computed Tomography Scans: Comparison of Eight Planimetric and Diametric Techniques Including a Step-By-Step Guide

“…First we measured TMA, followed by measurement of LPA as described before [7, 9, 13]. Additionally the widest anterior/posterior and transverse diameter of m. psoas (MP) was measured bilaterally [10, 14]. In order to approximate the TMA, we added the widest anterior/posterior and transverse diameter of the bilateral mm.…”