Sarcopenia is an independent risk factor for short-term mortality in patients undergoing transjugular intrahepatic portosystemic shunt.
| Autor: | Stoffel E; Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York City, New York., Hwang SY; Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.; University of Maryland Medical System, Baltimore, Maryland., Qian X; Department of Radiology, University of Florida, Gainesville, Florida.; Department of Pathology, Beth Israel Deaconess Hospital, Boston, Massachusetts., Geller B; Division of Gastroenterology and Hepatology, University of Florida, Gainesville, Florida, USA., Morelli G; Department of Radiology, University of Florida, Gainesville, Florida., Zhang W; Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. |
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| Jazyk: | angličtina |
| Zdroj: | European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2024 Aug 01; Vol. 36 (8), pp. 1010-1015. Date of Electronic Publication: 2024 May 27. |
| DOI: | 10.1097/MEG.0000000000002790 |
| Abstrakt: | Background: Sarcopenia is common in patients with cirrhosis and is a risk factor for increased mortality. Transjugular intrahepatic portosystemic shunt (TIPS) placement has been utilized in cirrhosis patients with decompensation . We investigated the role of sarcopenia in predicting mortality in patients undergoing TIPS. Methods: We conducted a single-center retrospective study of 232 patients with cirrhosis who underwent TIPS between January 2010 and December 2015. Sarcopenia was defined by the psoas muscle index (PMI) cutoff value, calculated based on dynamic time-dependent outcomes using X-tile software. Kaplan-Meier analysis demonstrated the difference in survival in the sarcopenia group versus the non-sarcopenia group. . Univariate and multivariate analyses were used to identify the relationship between sarcopenia and post-TIPS mortality during a follow-up period of 1 year. Results: For TIPS indications, 111 (47.84%) patients had refractory ascites, 69 (29.74%) patients had variceal bleeding, 12 (5.17%) patients had ascites, and 40 (17.24%) for other indications. The mean PMI was 4.40 ± 1.55. Sarcopenia was defined as a PMI value of <4.36 in males, and <3.23 in females. Sarcopenia was present in 96 (41.38%) of patients. . Kaplan-Meier analysis showed thatsarcopenia is associated with worse survival (log-rank P < 0.01). Multivariate Cox regression analysis showed that sarcopenia is independently associated with worse survival during the 1-year follow-up period with an hazard ratio of 2.435 (95% CI 1.346-4.403) ( P < 0.01), after adjusting for age, BMI, indications for TIPS, etiology for cirrhosis, and MELD score and stratified by sex. Conclusion: Sarcopenia is an independent risk factor for 1-year mortality in patients undergoing TIPS and should be considered when patients are evaluated as a candidate for TIPS. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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