Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis.
10.3346/jkms.2018.33.e299
- Author:
Jae Yoon JEONG
1
;
Sanghyeok LIM
;
Joo Hyun SOHN
;
Jae Gon LEE
;
Dae Won JUN
;
Yongsoo KIM
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. sonjh@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Liver Cirrhosis;
Sarcopenia;
Nutrition;
Mortality;
Prognosis
- MeSH:
Follow-Up Studies;
Humans;
Liver Cirrhosis*;
Liver Diseases, Alcoholic;
Liver*;
Mortality*;
Multivariate Analysis;
Muscle, Skeletal;
Prognosis;
Retrospective Studies;
Sarcopenia*;
Venous Pressure
- From:Journal of Korean Medical Science
2018;33(50):e299-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. METHODS: We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. RESULTS: A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (ΔSMA/y) were −0.89%. During a median follow-up period of 46.2 months (range, 3.4–87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ΔSMA/y were independently associated with mortality. Cumulative mortality was significantly higher in patients with ΔSMA/y <−2.4% than those with ΔSMA/y ≥−2.4% (log-rank test, P < 0.001). CONCLUSION: Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.
