Prevalence and prognosis of Computed-Tomography defined sarcopenia in Tunisian cirrhotic patients

• Published in: La Tunisie medicale Vol. 101; no. 4; p. 449
• Main Authors: Ayadi, Shema, Jrad, Myriam, Briki, Ines, Ayari, Myriam, Zaimi, Yosra, Leila, Mouelhi, Debbeche, Radhouane
• Format: Journal Article
• Language: English
• Published: Tunisia 05-04-2023
• Subjects: Female; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Middle Aged; Prevalence; Prognosis; Retrospective Studies; Sarcopenia - diagnostic imaging; Sarcopenia - epidemiology; Tomography, X-Ray Computed - methods
• ISSN: 2724-7031

Sarcopenia is an underdiagnosed and understudied complication of cirrhosis, especially in patients not undergoing liver transplantation.
To evaluate the prevalence and prognostic impact of radiological sarcopenia in non-transplanted cirrhotic patients.
Longitudinal retrospective study including cirrhotic patients explored by an abdominal CT scan, over a period of 6 years, in a single gastroenterology department in Tunisia. Sarcopenia was defined according to transversal psoas muscle thickness normalized to height (TPMT/h) in the sagittal CT slice. Two groups were defined: Group 1 with sarcopenia (TPMT/h <16.8mm/m); and Group 2 without sarcopenia (TPMT/h ≥16.8mm/m).
Seventy patients were included (mean age=62 years). The mean MELD score was 12.81 and the mean TPMT/h of 13.56 mm/m. Forty-four patients were sarcopenic (63%). When included, the 2 groups' baseline characteristics were comparable except for women predominance and refractory ascites in group 1. After an average of 21-month follow-up, sarcopenia was associated with a higher number of complications per patient (p=0.013) and a longer average hospital stay duration per patient (p=0.001). Overall survival was significantly decreased in sarcopenic patients (p=0.035). Survival rates at 6 months, 1 year, and 2 years were respectively 42%, 30%, and 24% in Group 1 versus 67%, 40%, and 27% in Group 2. Sarcopenia was an independent factor of mortality in multivariate analysis (OR=2.5; 95% IC [1.02-6.16]; p=0.045).
Sarcopenia is frequent and an independent poor prognostic factor in cirrhosis. TPMT/h is an easy and often available method for sarcopenia diagnosis.