Value of ultrasound in grading the severity of sarcopenia in patients with hepatic cirrhosis

Abstract

Background Ultrasound is emerging as an efficient significant method for measuring muscle mass in patients with liver cirrhosis. It has been applied in numerous studies as an accurate measuring tool for the muscles of the limbs. This study was conducted to assess the severity of sarcopenia in liver cirrhosis patients, through utilizing ultrasound in measuring the cross-sectional area and consequently estimating the muscle mass of both the upper and lower limb muscles, than correlating the results with hand grip strength as representative of functional status. Also, the severity of sarcopenia was correlated with conventional prognostic scores for liver cirrhosis, like Child or MELD scores and detecting its effect on the duration of hospital stay and mortality. Results This study was conducted on 101 liver cirrhosis patients who were admitted to the internal medicine hospital, 30 healthy participants were added as a control group. Using the FNIH (Foundation for the national Institutes of health) cuff off of hand grip (< 26 kg in male and < 16 kg in female, Quadriceps muscle index cutoff was estimated to be(1.67 cm/m2 for male and 1.58 cm/m2 for female). Ultrasound (mid upper arm, mid-thigh and Quadriceps muscle index) showed significant indirect correlation with (Child even in Child A and MELD) scores, as well as with the duration of hospital stay. Also, they showed a direct correlation with HGS. Conclusion Sarcopenia in cirrhotic patients assessed by ultrasonography of (mid upper arm, mid-thigh muscle thickness) and HGS are independent predictors of disease severity and poor outcome, which is assessed by high Child and MELD scores. Also, ultrasound and HGS are straightforward bedside techniques used for assessment of sarcopenia.

A Basic Review of Sarcopenia Diagnosis

“…Furthermore, ultrasound has been investigated to have the potential to assess small muscle groups [17] accurately. Though ultrasound is not included in the currently available guidelines, such as the EWGSOP and AWGS, the use of ultrasound as a diagnostic tool for muscle assessment in different patient populations has been evaluated in several studies, such as its use in hospitalized older adults, [18] patients receiving hemodialysis, [19] and patients with liver cirrhosis [20] to screen for sarcopenia or assess its severity. healthcare spending in old age is concentrated on long-term care, including difficulties in performing ADLs.…”