Abstract
Background: Sarcopenia has been reported as a prognostic factor. We evaluated the impact of sarcopenia to the conventional prognostic factors [Model for End-Stage Liver Disease (MELD) score, Child–Turcotte–Pugh (CTP) score, hepatic venous pressure gradient (HVPG)] in cirrhosis. Methods: Overall, 452 patients with cirrhosis were stratified by MELD score (low < 15, high ≥ 15), CTP class, and HVPG [non-clinically significant portal hypertension (CSPH), 6–9 mmHg; CSPH, 10–19 mmHg; extremely severe PH, ≥20 mmHg]. L3 skeletal muscle index as marker of sarcopenia was subdivided into quartiles (47.01–52.25–58.22 cm2/m2). Results: Among the patients, 42% (190/452) presented with sarcopenia. During a median follow-up period of 21.2 months, sarcopenia was associated with mortality (adjusted hazard ratio = 2.253, P < 0.001) and specifically with compensated and early decompensated stages of cirrhosis, but not with advanced decompensated stages; low (P < 0.001) and high (P = 0.095) MELD scores; CTP classes A (P = 0.034), B (P < 0.001), and C (P = 0.205); and non-CSPH (P = 0.018), CSPH (P < 0.001), and extremely severe PH (P = 0.846). In quartiles of sarcopenia, MELD score, CTP class, and HVPG were independent predictors of mortality in non-sarcopenia, but not in severe sarcopenia (MELD, P = 0.182; CTP, P = 0.187; HVPG, P = 0.077). Conclusions: Sarcopenia is associated with mortality in compensated and early decompensated cirrhosis, and existing conventional prognostic factors had limited value in severe sarcopenia. Therefore, incorporating sarcopenia in the conventional prognostic factors had added value, particularly in compensated and early decompensated cirrhosis. Subclassification of prognostic factors according to sarcopenia may help to better assess the prognosis of cirrhosis.
| Original language | English |
|---|---|
| Pages (from-to) | 860-870 |
| Number of pages | 11 |
| Journal | Journal of Cachexia, Sarcopenia and Muscle |
| Volume | 9 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2018 Oct |
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All Science Journal Classification (ASJC) codes
- Orthopedics and Sports Medicine
- Physiology (medical)
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Impact of sarcopenia on prognostic value of cirrhosis : going beyond the hepatic venous pressure gradient and MELD score. / Kang, Seong Hee; Jeong, Woo Kyoung; Baik, Soon Koo; Cha, Seung Hwan; Kim, Moon Young.
In: Journal of Cachexia, Sarcopenia and Muscle, Vol. 9, No. 5, 10.2018, p. 860-870.Research output: Contribution to journal › Article
TY - JOUR
T1 - Impact of sarcopenia on prognostic value of cirrhosis
T2 - going beyond the hepatic venous pressure gradient and MELD score
AU - Kang, Seong Hee
AU - Jeong, Woo Kyoung
AU - Baik, Soon Koo
AU - Cha, Seung Hwan
AU - Kim, Moon Young
PY - 2018/10
Y1 - 2018/10
N2 - Background: Sarcopenia has been reported as a prognostic factor. We evaluated the impact of sarcopenia to the conventional prognostic factors [Model for End-Stage Liver Disease (MELD) score, Child–Turcotte–Pugh (CTP) score, hepatic venous pressure gradient (HVPG)] in cirrhosis. Methods: Overall, 452 patients with cirrhosis were stratified by MELD score (low < 15, high ≥ 15), CTP class, and HVPG [non-clinically significant portal hypertension (CSPH), 6–9 mmHg; CSPH, 10–19 mmHg; extremely severe PH, ≥20 mmHg]. L3 skeletal muscle index as marker of sarcopenia was subdivided into quartiles (47.01–52.25–58.22 cm2/m2). Results: Among the patients, 42% (190/452) presented with sarcopenia. During a median follow-up period of 21.2 months, sarcopenia was associated with mortality (adjusted hazard ratio = 2.253, P < 0.001) and specifically with compensated and early decompensated stages of cirrhosis, but not with advanced decompensated stages; low (P < 0.001) and high (P = 0.095) MELD scores; CTP classes A (P = 0.034), B (P < 0.001), and C (P = 0.205); and non-CSPH (P = 0.018), CSPH (P < 0.001), and extremely severe PH (P = 0.846). In quartiles of sarcopenia, MELD score, CTP class, and HVPG were independent predictors of mortality in non-sarcopenia, but not in severe sarcopenia (MELD, P = 0.182; CTP, P = 0.187; HVPG, P = 0.077). Conclusions: Sarcopenia is associated with mortality in compensated and early decompensated cirrhosis, and existing conventional prognostic factors had limited value in severe sarcopenia. Therefore, incorporating sarcopenia in the conventional prognostic factors had added value, particularly in compensated and early decompensated cirrhosis. Subclassification of prognostic factors according to sarcopenia may help to better assess the prognosis of cirrhosis.
AB - Background: Sarcopenia has been reported as a prognostic factor. We evaluated the impact of sarcopenia to the conventional prognostic factors [Model for End-Stage Liver Disease (MELD) score, Child–Turcotte–Pugh (CTP) score, hepatic venous pressure gradient (HVPG)] in cirrhosis. Methods: Overall, 452 patients with cirrhosis were stratified by MELD score (low < 15, high ≥ 15), CTP class, and HVPG [non-clinically significant portal hypertension (CSPH), 6–9 mmHg; CSPH, 10–19 mmHg; extremely severe PH, ≥20 mmHg]. L3 skeletal muscle index as marker of sarcopenia was subdivided into quartiles (47.01–52.25–58.22 cm2/m2). Results: Among the patients, 42% (190/452) presented with sarcopenia. During a median follow-up period of 21.2 months, sarcopenia was associated with mortality (adjusted hazard ratio = 2.253, P < 0.001) and specifically with compensated and early decompensated stages of cirrhosis, but not with advanced decompensated stages; low (P < 0.001) and high (P = 0.095) MELD scores; CTP classes A (P = 0.034), B (P < 0.001), and C (P = 0.205); and non-CSPH (P = 0.018), CSPH (P < 0.001), and extremely severe PH (P = 0.846). In quartiles of sarcopenia, MELD score, CTP class, and HVPG were independent predictors of mortality in non-sarcopenia, but not in severe sarcopenia (MELD, P = 0.182; CTP, P = 0.187; HVPG, P = 0.077). Conclusions: Sarcopenia is associated with mortality in compensated and early decompensated cirrhosis, and existing conventional prognostic factors had limited value in severe sarcopenia. Therefore, incorporating sarcopenia in the conventional prognostic factors had added value, particularly in compensated and early decompensated cirrhosis. Subclassification of prognostic factors according to sarcopenia may help to better assess the prognosis of cirrhosis.
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U2 - 10.1002/jcsm.12333
DO - 10.1002/jcsm.12333
M3 - Article
C2 - 30371017
AN - SCOPUS:85055579793
VL - 9
SP - 860
EP - 870
JO - Journal of Cachexia, Sarcopenia and Muscle
JF - Journal of Cachexia, Sarcopenia and Muscle
SN - 2190-5991
IS - 5
ER -