Abstract
Objective: To investigate the frequency of sarcopenia in cirrhotic patients, the correlation of sarcopenia with conventional prognostic scores and its relationship with mortality by measuring the psoas muscle area at the level of mid-3rd lumbar (L3) vertebra on computed tomography (CT) scan. Materials and Methods: We included 229 cirrhotic patients who had undergone abdominal CT scan for hepatocellular carcinoma screening. A control group was formed in 204 healthy individuals who had undergone abdominal computed tomography examination due to trauma. 1- and 3-year follow-up results were recorded. Cross-sectional areas of the right and left psoas muscles were calculated in axial sections passing through the level of the mid-L3 in CT images. The cases with two standard deviations under the mean of the total psoas muscle area in control group were evaluated as sarcopenic. Results: Sarcopenia was detected in 39.7% of 229 cirrhotic patients. While a statistically significant difference was detected in the Child-Pugh prognostic score between cirrhotic patients with and without sarcopenia, there was a modest difference in the MELD score. The percentage of cirrhotic patients with sarcopenia who passed during 1- and 3- year follow-ups (28.6% and 40.7%, respectively) were significantly higher than non-sarcopenic patients (9.4% and 24.6%, respectively). Conclusion: The findings obtained in this study suggest that psoas muscle atrophy shown by CT scan image at the level of the mid-L3 vertebra has predictive value for mortality in cirrhotic patients.
Highlights
Sarcopenia is a syndrome characterised by loss of skeletal muscle mass and strength associated with risks of functional capacity, declining life quality and death [1]
Sarcopenia was detected in 39.7% of 229 cirrhotic patients
While a statistically significant difference was detected in the Child-Pugh prognostic score between cirrhotic patients with and without sarcopenia, there was a modest difference in the MELD score
Summary
Sarcopenia is a syndrome characterised by loss of skeletal muscle mass and strength associated with risks of functional capacity, declining life quality and death [1]. Sarcopenia is associated with aging, it has been shown to have a critical relationship with various clinical conditions, like malnutrition, chronic diseases and malignancy [1]. Erkan et al / Prognostic Value of Sarcopenia in Patients with Cirrhosis. Liver cirrhosis is one of major causes of death in many regions of the world and in our country. Life threatening complications, for instance variceal bleeding due to portal hypertension, ascites and spontaneous bacterial peritonitis, hepatic encephalopathy and liver failure may occur if they are not treated promptly [3]. Skeletal muscle depletion is a common feature of malnutrition in cirrhotic patients [4]
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