Sarcopoenia ups death risk in cirrhosis

Sarcopoenia is a strong and independent predictor of mortality risk in cirrhotic patients, reveals a recent meta-analysis.

Drawing from the databases of PubMed, Web of Science, and Embase, as well as searching through major scientific conference sessions, the researchers included 22 studies, yielding a cumulative sample of 6,965 cirrhotic patients. Only studies with ≥100 patients and with follow-up ≥12 months were eligible for inclusion.

Overall, 37.5 percent of patients had sarcopoenia, which was more likely to be detected among men, those with alcohol-associated liver disease (ALD), and Child-Pugh grade C cirrhosis. In turn, sarcopoenia increased the risk of mortality by more than twice (adjusted hazard ratio [HR], 2.30, 95 percent confidence interval [CI], 2.01–2.63).

Subsequent sensitivity analysis revealed that such risk aggravation remained significant even in the subset of patients without hepatocellular carcinoma (adjusted HR, 2.35, 95 percent CI, 1.95–2.83). Subgroup analysis according to sex, liver disease aetiology, and severity of hepatic dysfunction likewise did not affect the principal outcomes.

“Together, our findings suggest that: sarcopenia should be part of the initial evaluation of all patients with cirrhosis; all patients with cirrhosis regardless of degree of hepatic dysfunction should be monitored for sarcopenia on a regular basis; and additional studies are needed to incorporate sarcopenia or muscle mass index/function into a formal prognostic scale for patients with cirrhosis,” the researchers said.