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

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Published Sep 27, 2023
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Vol. 101 No. 4 (2023): Tunis Med apr 2023

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Shema Ayadi
Departement of Gastro-enterology, Charles Nicolle University Hospital, Tunis, Tunisia/ Factulty of medicine of Tunis- University ot Tunis El Manar- Tunis - Tunisia
Myriam Jrad
Department of Radiology, Charles Nicolle University Hospital, Tunis, Tunisia/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Ines Briki
Departement of Gastro-enterology, Charles Nicolle University Hospital, Tunis, Tunisia/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Myriam Ayari
Departement of Gastro-enterology, Charles Nicolle University Hospital, Tunis, Tunisia/ Factulty of medicine of Tunis- University ot Tunis El Manar- Tunis - Tunisia
Yosra Zaimi
Departement of Gastro-enterology, Charles Nicolle University Hospital, Tunis, Tunisia/ Factulty of medicine of Tunis- University ot Tunis El Manar- Tunis - Tunisia
Mouelhi Leila
Departement of Gastro-enterology, Charles Nicolle University Hospital, Tunis, Tunisia/ Factulty of medicine of Tunis- University ot Tunis El Manar- Tunis - Tunisia
Radhouane Debbeche
Departement of Gastro-enterology, Charles Nicolle University Hospital, Tunis, Tunisia/ Factulty of medicine of Tunis- University ot Tunis El Manar- Tunis - Tunisia

Abstract

Introduction: Sarcopenia is an underdiagnosed and understudied complication of cirrhosis, especially in patients not undergoing liver transplantation.


Aim: To evaluate the prevalence and prognostic impact of radiological sarcopenia in non-transplanted cirrhotic patients.


Methods: 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).


Results: 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).


Conclusion: Sarcopenia is frequent and an independent poor prognostic factor in cirrhosis. TPMT/h is an easy and often available method for sarcopenia diagnosis.


 

Keywords:

sarcopenia, malnutrition, cirrhosis, computed tomography, prognosis, mortality

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