Význam sarkopénie a krehkosti v manažmente cirhózy

Abstract

At present, we have enough tools for quick and accurate assessment of the muscle strength and functional status of a patient with cirrhosis. In recent years, the diagnostic criteria for sarcopenia and frailty are gradually merging into one, primarily for practical reasons. Both of them are equally negative predictors of disease development in hospitalized patients with cirrhosis regardless of the decision on the indication of liver transplantation, but also in patients on the waiting list, and in those after liver transplantation. Sarcopenia and frailty are strong and disease stage-independent predictors of mortality. Undiagnosed and untreated sarcopenia or frailty also increase the risk of falls and fractures, impair the natural ability to perform daily activities, and increase the degree of dependence on others. They are associated with a reduced cognitive function, higher risk of complications, reduced quality of life and prolonged hospitalization. Their early identification will enable the optimization of patient management with the immediate use of nutritional support and pre-habilitation in order to prevent further deterioration of functional status and avoid adverse consequences of the disease.