Sarcopenia as a Useful Predictor for Long-Term Mortality in Cirrhotic Patients with Ascites.
10.3346/jkms.2014.29.9.1253
- Author:
Tae Yeob KIM
1
;
Min Yeong KIM
;
Joo Hyun SOHN
;
Sun Min KIM
;
Jeong Ah RYU
;
Sanghyeok LIM
;
Youngsoo KIM
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University, Guri, Korea. sonjh@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Ascites;
Liver Cirrhosis;
Prognosis;
Psoas Muscle Thickness;
Sarcopenia
- MeSH:
Adult;
Aged;
Area Under Curve;
*Ascites;
Female;
Follow-Up Studies;
Humans;
Liver Cirrhosis/complications/*mortality;
Male;
Middle Aged;
Predictive Value of Tests;
Prognosis;
ROC Curve;
Regression Analysis;
Sarcopenia/*diagnosis/etiology/radiography;
Severity of Illness Index;
Survival Analysis;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2014;29(9):1253-1259
- CountryRepublic of Korea
- Language:English
-
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< or =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< or =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.
