Is rectus abdominis thickness associated with survival among patients with liver cirrhosis? A prospective cohort study
São Paulo med. j
;
137(5): 401-406, Sept.-Oct. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1059101
ABSTRACT
ABSTRACT BACKGROUND:
Sarcopenia may affect patients with liver cirrhosis and worsen disease outcomes.OBJECTIVES:
To evaluate ultrasound-measured psoas major (PM) and rectus abdominis (RA) thickness for predicting survival among patients with liver cirrhosis. DESIGN ANDSETTING:
Prospective cohort study in a tertiary-level hospital.METHODS:
61 patients with liver cirrhosis were prospectively included during a 15-month period and followed up for at least six months. Cirrhosis was classified using the Child-Pugh score. Sarcopenia was assessed using surrogate parameters handgrip strength (HGS), mid-arm muscle circumference (MAMC) and SGA (subjective global assessment). We used ultrasound to measure RA and PM thickness at admission.RESULTS:
There were 41 men. The patients' mean age was 58.03 ± 10.8 years. 26.22% of them were Child-Pugh A, 45.9% B and 27.86% C. The patients were followed up for 11.9 ± 5.63 months. RA thickness correlated moderately with MAMC (r = 0. 596; P < 0.0001) and HGS (r = 0.515; P < 0.0001) and decreased with increasing SGA class (A, 10.6 ± 2.8 mm; B, 8.3 ± 1.9 mm; C, 6.5 ± 1.9 mm; P < 0.0001). Survival at six months was independently predicted by using the model for end-stage liver disease-serum sodium score (odds ratio, OR 1.305; 95% OR confidence interval 1.083-1.572; P = 0.005). Survival during follow-up was independently predicted by RA thickness (hazard ratio, HR 0.701; 95% HR confidence interval 0.533-0.922; P = 0.011) and ascites (HR 1.876; 95% HR confidence interval 1.078-3.267; P = 0.026). PM thickness did not have any predictive value.CONCLUSIONS:
As a surrogate marker of sarcopenia, RA thickness may predict survival among patients with liver cirrhosis.
Full text:
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Index:
LILACS (Americas)
Main subject:
Rectus Abdominis
/
Sarcopenia
/
Liver Cirrhosis
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicine
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2019
Type:
Article
Affiliation country:
Romania
Institution/Affiliation country:
Carol Davila University of Medicine and Pharmacy/RO
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