Sarcopenia Does Not Worsen Survival in Patients With Cirrhosis Undergoing Transjugular Intrahepatic Portosystemic Shunt for Refractory Ascites
| Autor: | Dominic Yu, Gioacchino Leandro, Francesco Arico, Emmanuel Tsochatzis, Felix Cheng, Becky Yu, Davide Roccarina, Amine Benmassaoud, David Patch |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cirrhosis Hepatology medicine.diagnostic_test business.industry medicine.medical_treatment Gastroenterology medicine.disease 03 medical and health sciences Liver disease 0302 clinical medicine 030220 oncology & carcinogenesis Sarcopenia Internal medicine Paracentesis medicine 030211 gastroenterology & hepatology business Survival rate Hepatic encephalopathy Contraindication Transjugular intrahepatic portosystemic shunt |
| Zdroj: | American Journal of Gastroenterology. 115:1911-1914 |
| ISSN: | 1572-0241 0002-9270 |
| Popis: | Introduction The impact of sarcopenia in patients undergoing transjugular intrahepatic portosystemic shunt (TIPSS) insertion for refractory ascites is unknown. Methods All adult patients who underwent TIPSS insertion for refractory ascites between 2010 and 2018 were included. Skeletal muscle index at L3 was used to determine sarcopenia status. Results One hundred seven patients were followed for 14.2 months. Sarcopenia was present in 57% of patients. No patient had history of pre-TIPSS hepatic encephalopathy (HE). De novo HE occurred in 30% of patients. On multivariate analysis, only platelet count and L3-SMI predicted de novo HE. On multivariate analysis, age and model for end-stage liver disease with sodium predicted mortality, whereas L3-SMI and sarcopenia did not. In patients with repeat imaging, L3-SMI improved significantly post-TIPSS compared with baseline. Discussion Sarcopenia should not be considered as a contraindication to TIPSS insertion in refractory ascites because it is not associated with de novo HE or increased mortality. |
| Databáze: | OpenAIRE |
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