Background: Since the use of the Model for End-Stage Liver Disease (MELD) score for establishing the prognosis of cirrhotic patients has been introduced, questions have been raised whether complications of liver cirrhosis would provide additional information. Myosteatosis, sarcopenia and hepatic encephalopathy (HE) are frequent in cirrhosis and may affect prognosis.Aim of the study was analyzing if these factors are independently related to survival and may improve the accuracy of MELD.Methods: 249 cirrhotics that underwent abdominal CT-scan were enrolled. For each patient, information about previous episodes of HE and muscle alterations were obtained. Patients were followed until transplantation or death.Results: History of HE, MELD, sarcopenia and myosteatosis were independently associated with mortality. The MELD-Sarco-Myo-HE score added accuracy to the MELD score alone for 6- and 3-months mortality. By removing HE, as the only not quantifiable parameter of the model, no relevant decrease in accuracy for 6- and 3-months mortality detection was observed.Conclusions: The accuracy of MELD in predicting 3- and 6-months mortality may be improved by considering the muscle alterations. A model considering the above parameters may classify more accurately over 30% of the patients. (C) 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Lattanzi, B., Nardelli, S., Pigliacelli, A., Di Cola, S., Farcomeni, A., D'Ambrosio, D., et al. (2019). The additive value of sarcopenia, myosteatosis and hepatic encephalopathy in the predictivity of model for end-stage liver disease. DIGESTIVE AND LIVER DISEASE, 51(11), 1508-1512 [10.1016/j.dld.2019.09.004].

The additive value of sarcopenia, myosteatosis and hepatic encephalopathy in the predictivity of model for end-stage liver disease

Farcomeni A.;
2019-01-01

Abstract

Background: Since the use of the Model for End-Stage Liver Disease (MELD) score for establishing the prognosis of cirrhotic patients has been introduced, questions have been raised whether complications of liver cirrhosis would provide additional information. Myosteatosis, sarcopenia and hepatic encephalopathy (HE) are frequent in cirrhosis and may affect prognosis.Aim of the study was analyzing if these factors are independently related to survival and may improve the accuracy of MELD.Methods: 249 cirrhotics that underwent abdominal CT-scan were enrolled. For each patient, information about previous episodes of HE and muscle alterations were obtained. Patients were followed until transplantation or death.Results: History of HE, MELD, sarcopenia and myosteatosis were independently associated with mortality. The MELD-Sarco-Myo-HE score added accuracy to the MELD score alone for 6- and 3-months mortality. By removing HE, as the only not quantifiable parameter of the model, no relevant decrease in accuracy for 6- and 3-months mortality detection was observed.Conclusions: The accuracy of MELD in predicting 3- and 6-months mortality may be improved by considering the muscle alterations. A model considering the above parameters may classify more accurately over 30% of the patients. (C) 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore SECS-S/01
English
Hepatic encephalopathy
Model for end-stage liver disease
Myosteatosis
Sarcopenia
Aged
End Stage Liver Disease
Female
Hepatic Encephalopathy
Humans
Liver Cirrhosis
Liver Function Tests
Male
Middle Aged
Muscle, Skeletal
Prognosis
ROC Curve
Retrospective Studies
Sarcopenia
Severity of Illness Index
Tomography, X-Ray Computed
Lattanzi, B., Nardelli, S., Pigliacelli, A., Di Cola, S., Farcomeni, A., D'Ambrosio, D., et al. (2019). The additive value of sarcopenia, myosteatosis and hepatic encephalopathy in the predictivity of model for end-stage liver disease. DIGESTIVE AND LIVER DISEASE, 51(11), 1508-1512 [10.1016/j.dld.2019.09.004].
Lattanzi, B; Nardelli, S; Pigliacelli, A; Di Cola, S; Farcomeni, A; D'Ambrosio, D; Gioia, S; Ginanni Corradini, S; Lucidi, C; Mennini, G; Rossi, M; Merli, M; Riggio, O
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/278618
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