Sarcopenia as a useful predictor for long-term mortality in cirrhotic patients with ascites

• Published in: Journal of Korean medical science 2014, 29(9), 192, pp.1253-1259
• Main Authors: Kim, Tae Yeob, Kim, Min Yeong, Sohn, Joo Hyun, Kim, Sun Min, Ryu, Jeong Ah, Lim, Sanghyeok, Kim, Youngsoo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Area Under Curve; Ascites; Female; Follow-Up Studies; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - mortality; Male; Middle Aged; Original; Predictive Value of Tests; Prognosis; Regression Analysis; ROC Curve; Sarcopenia - diagnosis; Sarcopenia - diagnostic imaging; Sarcopenia - etiology; Severity of Illness Index; Survival Analysis; Tomography, X-Ray Computed; 의학일반
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2014.29.9.1253

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 (P14 mm/m (HR, 5.398; 95% CI, 2.111-13.800, P