Department of Gastroenterology and Hepatology, University Medical Center Brandenburg, Brandenburg, Germany.
Brandenburg Medical School, University Medical Center Brandenburg, Brandenburg, Germany.
Medicine (Baltimore). 2022 Sep 9;101(36):e30259. doi: 10.1097/MD.0000000000030259.
Sarcopenia is frequent in liver cirrhosis (LC) where it is associated with morbidity and mortality. However, prognostic scores such as model for end-stage liver disease (MELD), MELD-sodium (MELD-Na), or Child-Turcotte-Pugh (CTP) do not contain sarcopenia as a variable. For this study, we utilized psoas muscle index (PMI) to objectively determine sarcopenia in hospitalized LC patients, and evaluated it as a predictor of time between discharge and readmission in LC. Abdominal computed tomography and magnetic resonance imaging scans of 65 consecutive LC patients were retrospectively examined to determine PMI. MELD, MELD-Na, and CTP were calculated from clinical data. PMI was then combined with CTP to form an experimental score: CTP sarcopenia (CTPS). For PMI alone and for each score, correlation with time between discharge and readmission for liver-related complications was calculated. PMI was also tested for correlation with sex, body mass index (BMI), MELD, MELD-Na, and CTP. CTPS was most closely correlated with time to readmission (R = 0.730; P < .001), followed by CTP (R = 0.696; P < .001), MELD-Na (R = 0.405; P = .009), and PMI alone (R = 0.388; P = .01). Correlation with MELD (R = 0.354; P = .05) was lowest. Additionally, there were significant differences in PMI between male and female individuals (5.16 vs 4.54 cm2/m2; P = .04) and in BMI between sarcopenic and nonsarcopenic individuals (29.63 vs 25.88 kg/m2; P = .009). Sarcopenia is an independent short-term prognostic factor in LC. By combining data on sarcopenia with CTP, we created an experimental score that predicts time to readmission better than MELD, MELD-Na, or CTP.
肌肉减少症在肝硬化（LC）中很常见，与发病率和死亡率相关。然而，预后评分如终末期肝病模型（MELD）、MELD 钠（MELD-Na）或 Child-Turcotte-Pugh（CTP）并不包含肌肉减少症作为一个变量。在这项研究中，我们利用腰大肌指数（PMI）客观地确定住院 LC 患者的肌肉减少症，并评估其作为 LC 患者出院后再入院时间的预测因子。回顾性检查了 65 例连续 LC 患者的腹部计算机断层扫描和磁共振成像扫描，以确定 PMI。MELD、MELD-Na 和 CTP 从临床数据中计算得出。然后将 PMI 与 CTP 结合形成一个实验评分：CTP 肌肉减少症（CTPS）。对于 PMI 本身和每个评分，计算与因肝相关并发症而出院后再入院之间的时间的相关性。还测试了 PMI 与性别、体重指数（BMI）、MELD、MELD-Na 和 CTP 的相关性。CTPS 与再入院时间相关性最强（R = 0.730；P <.001），其次是 CTP（R = 0.696；P <.001）、MELD-Na（R = 0.405；P =.009）和单独的 PMI（R = 0.388；P =.01）。与 MELD 的相关性最低（R = 0.354；P =.05）。此外，男性和女性个体之间的 PMI 存在显著差异（5.16 与 4.54 cm2/m2；P =.04），肌肉减少症和非肌肉减少症个体之间的 BMI 存在显著差异（29.63 与 25.88 kg/m2；P =.009）。肌肉减少症是 LC 的一个独立短期预后因素。通过将肌肉减少症数据与 CTP 相结合，我们创建了一个实验评分，该评分比 MELD、MELD-Na 或 CTP 更能预测再入院时间。
