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Bedside assessment of sarcopenia in hospitalized patients with liver cirrhosis: Magnitude and clinical implications.
Prakash, Sabbu Surya; Priyadarshi, Rajeev Nayan; Surya, Himanshu; Kumar, Sudhir; Anand, Utpal; Kumar, Ramesh.
Afiliación
  • Prakash SS; Department of Gastroenterology, All India Institute of Medical Sciences, 4th Floor, OPD, D-Block, Patna, 801507, India.
  • Priyadarshi RN; Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, 801 507, India.
  • Surya H; Department of Gastroenterology, All India Institute of Medical Sciences, 4th Floor, OPD, D-Block, Patna, 801507, India.
  • Kumar S; Department of Gastroenterology, All India Institute of Medical Sciences, 4th Floor, OPD, D-Block, Patna, 801507, India.
  • Anand U; Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, 801 507, India.
  • Kumar R; Department of Gastroenterology, All India Institute of Medical Sciences, 4th Floor, OPD, D-Block, Patna, 801507, India. docrameshkr@gmail.com.
Indian J Gastroenterol ; 43(4): 821-831, 2024 Aug.
Article en En | MEDLINE | ID: mdl-39060903
ABSTRACT

BACKGROUND:

Sarcopenia is associated with many adverse outcomes in patients with cirrhosis. The tools currently in use for assessing sarcopenia have numerous flaws. We evaluated the utility of portable ultrasonography and a dynamometer for the bedside assessment of sarcopenia and its implications in hospitalized cirrhosis patients.

METHODS:

A dynamometer was used to test the hand-grip strength (HGS) and ultrasound was used to measure the thickness of the forearm and quadriceps muscles. HGS value < 27 kg for men and < 16 kg for women was taken as significant according to the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. The lower normal limit of muscle mass (5th percentile) was determined on 100 matched healthy controls.

RESULTS:

According to the EWGSOP2 criteria and HGS values, the prevalence of sarcopenia and probable sarcopenia among 300 cirrhosis patients were 56% and 62.3%, respectively. HGS alone identified sarcopenia in 88.9% of patients, while overestimated it in 6.3% of cases. The prevalence rate of sarcopenic obesity was 11%. Compared to patients without sarcopenia, sarcopenic patients had more complications of cirrhosis such as ascites, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, sepsis, hepatorenal syndrome and refractory ascites. In-hospital (p = 0.037), three-month (p < 0.001), and six-month (p < 0.001) mortality rates were all higher among sarcopenic patients. On cox regression survival analysis, overall six-month mortality was significantly higher in sarcopenic patients compared to patients without sarcopenia (hazard ratio, 6.37; 95% confidence interval, 3.15-12.8, p < 0.001).

CONCLUSION:

Bedside assessment of sarcopenia using a portable ultrasound machine and a dynamometer detects liver cirrhosis patients with high risk of complications and mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ultrasonografía / Fuerza de la Mano / Sarcopenia / Hospitalización / Cirrosis Hepática Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Indian J Gastroenterol Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India
Texto completo
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Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ultrasonografía / Fuerza de la Mano / Sarcopenia / Hospitalización / Cirrosis Hepática Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Indian J Gastroenterol Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India