Abstract
Background
The relationship between the improvement of sarcopenia and post-TIPS prognosis has
not been fully investigated.
Aims
To assess what level of sarcopenia improvement is required for potential benefits
to post-TIPS prognosis.
Methods
In this retrospective study, 109 cirrhotic patients with sarcopenia who underwent
TIPS between February 2016 and January 2021 were included. The change in skeletal
muscle index (SMI) at 6 months post-TIPS was assessed and the correlations of SMI
improvement with clinical outcomes were analyzed.
Results
During follow up, 59 (65.6%) patients reversed from sarcopenic to non-sarcopenic,
and the cumulative mortality (8.5 % vs. 26.0%, log rank P = 0.013) and incidence of overt hepatic encephalopathy (OHE) (18.6% vs. 44.0%, log
rank P = 0.004) in patients who reversed were significantly lower than who did not. SMI
improvement rate was identified as an independent risk factor for mortality and OHE.
In addition, the cumulative survival rate of patients with sarcopenia reversal or
SMI improvement rate > 10.4% was significantly higher than that of patients with an
SMI improvement rate ≤ 10.4% (92.5% vs. 58.6%, log rank P < 0.001).
Conclusion
Reversal of sarcopenia or significant SMI improvement by TIPS could reduce the risk
of death and OHE.
Keywords
Abbreviations:
AUC (area under the curve), BIA (bioelectrical impedance analysis), BMI (body mass index), CI (confidence interval), DEXA (dual-energy X-ray absorptiometry), EASL (European Association for the Study of the Liver), HE (hepatic encephalopathy), HR (hazard ratio), HU (Hounsfield unit), MELD (model for end-stage liver disease), PPG (portal pressure gradient), ROC (receiver operating characteristics), SMA (skeletal muscle area), SMI (skeletal muscle index), TIPS (transjugular intrahepatic portosystemic shunt)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 20, 2023
Accepted:
January 1,
2023
Received:
July 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
