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http://dx.doi.org/10.3346/jkms.2018.33.e299

Presence of Sarcopenia and Its Rate of Change Are Independently Associated with Long-term Mortality in Patients with Liver Cirrhosis  

Jeong, Jae Yoon (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Lim, Sanghyeok (Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Sohn, Joo Hyun (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Lee, Jae Gon (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Jun, Dae Won (Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine)
Kim, Yongsoo (Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Publication Information
Journal of Korean Medical Science / v.33, no.50, 2018 , pp. 299.1-299.13 More about this Journal
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 (${\Delta}SMA/y$) 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 ${\Delta}SMA/y$ were independently associated with mortality. Cumulative mortality was significantly higher in patients with ${\Delta}SMA/y$ < -2.4% than those with ${\Delta}SMA/y{\geq}-2.4%$ (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.
Keywords
Liver Cirrhosis; Sarcopenia; Nutrition; Mortality; Prognosis;
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