Audrey Huguet1, Marianne Latournerie2, Pauline Houssel Debry1, Caroline Jezequel1, Ludivine Legros1, Michel Rayar3, Karim Boudjema3, Dominique Guyader4, Edouard Bardou Jacquet4, Ronan Thibault5. 1. Service des Maladies du Foie, CHU Rennes, Université Rennes 1, Rennes, France. 2. Service des Maladies du Foie, CHU Rennes, Université Rennes 1, Rennes, France; Service d'Hépato-gastroentérologie, CHU François Mitterrand, Dijon, France. 3. Service de Chirurgie Hépatobiliaire et Digestive, CHU Rennes, Université Rennes 1, Rennes, France. 4. Service des Maladies du Foie, CHU Rennes, Université Rennes 1, Rennes, France; Institut NuMeCan, INSERM, INRA, Université Rennes 1, Rennes, France. 5. Institut NuMeCan, INSERM, INRA, Université Rennes 1, Rennes, France; Unité de Nutrition, CHU Rennes, Université Rennes 1, Rennes, France. Electronic address: ronan.thibault@chu-rennes.fr.
Abstract
OBJECTIVE: Malnutrition impairs prognosis in liver cirrhosis. Our aims were to determine (1) if transversal (TPTI) and axial (APTI) psoas thickness indices predict mortality in cirrhotic patients and (2) the feasibility and reproducibility of transversal (TDPM) and axial (ADPM) diameters of the psoas muscle measurements. METHODS: This was a retrospective study. Inclusion criteria included cirrhosis diagnosis, on liver transplantation waiting list, and abdominal computed tomography (CT) scan within the 3 mo preceding list inscription. TDPM and ADPM were measured on a single umbilicus-targeted CT image by non-expert and expert operators. TPTI or APTI (mm/m) were calculated as TDPM or ADPM/height (m). Area under the receiver operating characteristic curve (AUC) and Cox proportional hazard models were assessed. TPTI and APTI interobserver agreement: κ correlation test. RESULTS: A total of 173 patients were included. Low TPTI was associated with increased mortality: AUC = 0.66 (95% confidence interval, 0.51-0.80). TPTI was the only factor associated with mortality (hazard ratio = 0.87, 95% confidence interval 0.76-0.99, P = 0.034). There was an almost perfect interobserver agreement between the two operators: TDPM, κ = 0.97; ADPM, κ = 0.94; P <0.0001. CONCLUSIONS: TPTI measured on umbilicus-targeted CT scan before inscription on the waiting list for liver transplantation predicts mortality of cirrhotic patients. TPTI measurement is easy and reliable, even by a non-trained operator, and this is highly feasible in daily clinical practice.
OBJECTIVE: Malnutrition impairs prognosis in liver cirrhosis. Our aims were to determine (1) if transversal (TPTI) and axial (APTI) psoas thickness indices predict mortality in cirrhotic patients and (2) the feasibility and reproducibility of transversal (TDPM) and axial (ADPM) diameters of the psoas muscle measurements. METHODS: This was a retrospective study. Inclusion criteria included cirrhosis diagnosis, on liver transplantation waiting list, and abdominal computed tomography (CT) scan within the 3 mo preceding list inscription. TDPM and ADPM were measured on a single umbilicus-targeted CT image by non-expert and expert operators. TPTI or APTI (mm/m) were calculated as TDPM or ADPM/height (m). Area under the receiver operating characteristic curve (AUC) and Cox proportional hazard models were assessed. TPTI and APTI interobserver agreement: κ correlation test. RESULTS: A total of 173 patients were included. Low TPTI was associated with increased mortality: AUC = 0.66 (95% confidence interval, 0.51-0.80). TPTI was the only factor associated with mortality (hazard ratio = 0.87, 95% confidence interval 0.76-0.99, P = 0.034). There was an almost perfect interobserver agreement between the two operators: TDPM, κ = 0.97; ADPM, κ = 0.94; P <0.0001. CONCLUSIONS: TPTI measured on umbilicus-targeted CT scan before inscription on the waiting list for liver transplantation predicts mortality of cirrhotic patients. TPTI measurement is easy and reliable, even by a non-trained operator, and this is highly feasible in daily clinical practice.
Authors: Toshifumi Yodoshi; Sarah Orkin; Ana-Catalina Arce Clachar; Kristin Bramlage; Qin Sun; Lin Fei; Andrew F Beck; Stavra A Xanthakos; Andrew T Trout; Marialena Mouzaki Journal: J Pediatr Date: 2020-08 Impact factor: 4.406
Authors: Rafael Paternostro; Constanze Bardach; Benedikt S Hofer; Bernhard Scheiner; Philipp Schwabl; Ulrika Asenbaum; Ahmed Ba-Ssalamah; Martina Scharitzer; Theresa Bucscis; Benedikt Simbrunner; David Bauer; Michael Trauner; Mattias Mandorfer; Thomas Reiberger; Katharina Lampichler Journal: Liver Int Date: 2020-12-22 Impact factor: 5.828