Background: The role of sarcopenia in predicting decompensation other than hepatic encephalopathy is unclear. We aimed to evaluate the prognostic role of sarcopenia, assessed by computed tomography (CT), in the development of ascites and mortality in patients with advanced chronic liver disease (ACLD) outside the liver transplantation (LT) setting. Material and Methods: We retrospectively evaluated ACLD patients with liver stiffness measurement (LSM) >10 kPa and an available CT scan within 6 months. Sarcopenia was defined as skeletal muscle index (SMI) <50 and <39 cm2/m2, respectively, in men and women. Competing risk regression models were used to assess the variables associated with the main outcomes. Results: 209 patients were included in the final analysis and sarcopenia was present in 134 (64.1%). During a median follow-up of 37 (20–63) months, 52 patients developed ascites, 24 underwent LT, and 30 died. Sarcopenia was found a predictive factor of decompensation with ascites (SHR 2.083, 95%-CI: 1.091–3.978), independently from the features of clinically significant portal hypertension (LSM≥21 kPa or portosystemic shunts). Sarcopenia (SHR: 2.744, 95%-CI: 1.105–6.816) and LSM≥21 kPa (SHR: 3.973, 95%-CI: 1.548–10.197) were independent risk factors for increased mortality. Conclusions: Sarcopenia and portal hypertension are two major and independent risk factors for decompensation with ascites and mortality in cirrhotic patients outside the LT context.

The interplay between sarcopenia and portal hypertension predicts ascites and mortality in cirrhosis / Dajti, E.; Renzulli, M.; Ravaioli, F.; Marasco, G.; Vara, G.; Brandi, N.; Rossini, B.; Colecchia, L.; Alemanni, L. V.; Ferrarese, A.; Vestito, A.; Tame, M.; Azzaroli, F.; Festi, D.; Golfieri, R.; Colecchia, A.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 55:5(2022), pp. 637-643. [10.1016/j.dld.2022.11.011]

The interplay between sarcopenia and portal hypertension predicts ascites and mortality in cirrhosis

Colecchia A.
2022

Abstract

Background: The role of sarcopenia in predicting decompensation other than hepatic encephalopathy is unclear. We aimed to evaluate the prognostic role of sarcopenia, assessed by computed tomography (CT), in the development of ascites and mortality in patients with advanced chronic liver disease (ACLD) outside the liver transplantation (LT) setting. Material and Methods: We retrospectively evaluated ACLD patients with liver stiffness measurement (LSM) >10 kPa and an available CT scan within 6 months. Sarcopenia was defined as skeletal muscle index (SMI) <50 and <39 cm2/m2, respectively, in men and women. Competing risk regression models were used to assess the variables associated with the main outcomes. Results: 209 patients were included in the final analysis and sarcopenia was present in 134 (64.1%). During a median follow-up of 37 (20–63) months, 52 patients developed ascites, 24 underwent LT, and 30 died. Sarcopenia was found a predictive factor of decompensation with ascites (SHR 2.083, 95%-CI: 1.091–3.978), independently from the features of clinically significant portal hypertension (LSM≥21 kPa or portosystemic shunts). Sarcopenia (SHR: 2.744, 95%-CI: 1.105–6.816) and LSM≥21 kPa (SHR: 3.973, 95%-CI: 1.548–10.197) were independent risk factors for increased mortality. Conclusions: Sarcopenia and portal hypertension are two major and independent risk factors for decompensation with ascites and mortality in cirrhotic patients outside the LT context.
2022
55
5
637
643
The interplay between sarcopenia and portal hypertension predicts ascites and mortality in cirrhosis / Dajti, E.; Renzulli, M.; Ravaioli, F.; Marasco, G.; Vara, G.; Brandi, N.; Rossini, B.; Colecchia, L.; Alemanni, L. V.; Ferrarese, A.; Vestito, A.; Tame, M.; Azzaroli, F.; Festi, D.; Golfieri, R.; Colecchia, A.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 55:5(2022), pp. 637-643. [10.1016/j.dld.2022.11.011]
Dajti, E.; Renzulli, M.; Ravaioli, F.; Marasco, G.; Vara, G.; Brandi, N.; Rossini, B.; Colecchia, L.; Alemanni, L. V.; Ferrarese, A.; Vestito, A.; Tame, M.; Azzaroli, F.; Festi, D.; Golfieri, R.; Colecchia, A.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1313239
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