Filip Petruta Violeta, Cuciureanu Denisa, Pop Corina Silvia, Marinescu Andreea Nicoleta, Furtunescu Florentina, Diaconu Laura Sorina
Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine, 020021 Bucharest, Romania.
Departments of Internal Medicine and Gastroenterology, Bucharest University Emergency Hospital, 050098 Bucharest, Romania.
Diagnostics (Basel). 2024 Dec 25;15(1):16. doi: 10.3390/diagnostics15010016.
: Sarcopenia and frailty are both multidimensional and interrelated problems for patients with cirrhosis and require prompt assessment and appropriate management because of their impact on disease outcomes. Our purpose is to identify the prevalence of sarcopenia and frailty in patients with advanced liver disease. Furtherksdnvk more, our purpose is to explore the association between sarcopenia, frailty, and various complications and the impact of these conditions on short- and long-term hospital survival rates. : A prospective, observational, unicentric study was conducted in an emergency university hospital in Romania between January 2021 and December 2023 that included patients with advanced liver diseases. The patients with sarcopenia and frailty were selected using measurements of handgrip strength (HGS), Short Physical Performance Battery (SPPB), liver frailty index (LFI), and skeletal muscle index (SMI). Patients were divided into four groups based on the presence of sarcopenia and/or frailty. : This study included 128 patients. Younger patients associated with both sarcopenia and frailty (55.76 ± 10.46 years). Most males were without sarcopenia and frailty (63.93%) compared to those with both sarcopenia and frailty (36.07%). The Child-Pugh score C was identified in the majority of those with both sarcopenia and frailty (69.70%). Higher values for MELD-Na scores were obtained in the group with sarcopenia and frailty (25.45 ± 6.924). Biomarkers like albumin, sodium, C-reactive protein, bilirubin, and platelets were statistically significant as mortality predictors in all four groups. Patients with both sarcopenia and frailty presented more often with encephalopathy and spontaneous bacterial peritonitis. Survival rates in the short and long term were lower for the patients who associated both sarcopenia and frailty compared to those without sarcopenia and frailty. The presence of sarcopenia and frailty significantly impacts outcomes in patients with decompensated advanced liver disease. When both conditions coexist in the same patient, they markedly increase in-hospital mortality, as well as short- and long-term survival rates.
肌肉减少症和衰弱症对于肝硬化患者来说都是多维度且相互关联的问题，由于它们对疾病转归有影响，因此需要及时评估和适当管理。我们的目的是确定晚期肝病患者中肌肉减少症和衰弱症的患病率。此外，我们的目的是探讨肌肉减少症、衰弱症与各种并发症之间的关联，以及这些情况对短期和长期住院生存率的影响。：2021年1月至2023年12月期间，在罗马尼亚一家大学急诊医院进行了一项前瞻性、观察性、单中心研究，纳入了晚期肝病患者。通过测量握力（HGS）、简易体能状况量表（SPPB）、肝脏衰弱指数（LFI）和骨骼肌指数（SMI）来选择患有肌肉减少症和衰弱症的患者。根据是否存在肌肉减少症和/或衰弱症将患者分为四组。：本研究包括128名患者。同时患有肌肉减少症和衰弱症的患者较为年轻（55.76±10.46岁）。与同时患有肌肉减少症和衰弱症的男性相比，大多数男性没有肌肉减少症和衰弱症（63.93%）。在大多数同时患有肌肉减少症和衰弱症的患者中发现了Child-Pugh C级评分（69.70%）。肌肉减少症和衰弱症组的终末期肝病模型钠（MELD-Na）评分较高（25.45±6.924）。白蛋白、钠、C反应蛋白、胆红素和血小板等生物标志物在所有四组中作为死亡率预测指标具有统计学意义。同时患有肌肉减少症和衰弱症的患者更常出现肝性脑病和自发性细菌性腹膜炎。与没有肌肉减少症和衰弱症的患者相比，同时患有肌肉减少症和衰弱症的患者短期和长期生存率较低。肌肉减少症和衰弱症的存在对失代偿期晚期肝病患者的转归有显著影响。当这两种情况在同一患者中同时存在时，它们会显著增加住院死亡率以及短期和长期生存率。
