Muscle volume loss a prognostic factor for death in liver cirrhosis patients and special relationship to portal hypertension. Issue 3 (18th October 2017)

• Record Type: Journal Article
• Authors: Hiraoka, Atsushi; Kitahata, Shogo; Izumoto, Hirofumi; Ueki, Hidetaro; Aibiki, Toshihiko; Okudaira, Tomonari; Miyamoto, Yuji; Yamago, Hiroka; Iwasaki, Ryuichiro; Tomida, Hideomi; Mori, Kenichiro; Kishida, Masato; Tsubouchi, Eiji; Miyata, Hideki; Ninomiya, Tomoyuki; Hirooka, Masashi; Tokumoto, Yoshio; Abe, Masanori; Matsuura, Bunzo; Hiasa, Yoichi; Michitaka, Kojiro
• Is Part Of: Hepatology research. Volume 48:Issue 3(2018)
• Page Start: E354
• Page End: E359
• Publication Date: 2017-10-18
• Subjects: esophagogastric varices -- liver cirrhosis -- muscle volume loss -- portal hypertension -- prognosis; Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.12984
• Languages: English
• ISSNs: 1386-6346

Abstract

Abstract : Aim: We examined the prognosis of liver cirrhosis (LC) patients with and without portal hypertension (PHT) and muscle volume loss (MVL). Methods: From 2006 to 2016, 346 LC outpatients (PHT/non‐PHT = 173/173) were enrolled (median age, 69 years; men / women, 204/142; Child–Pugh A / B, 230/116; and presence of MVL 15.6% in each group) after propensity matching, following exclusion of those with hepatocellular carcinoma (HCC) beyond the Milan criteria and Child–Pugh C. Portal hypertension was defined as positive for significant esophagogastric varices; MVL was diagnosed based on a previously reported index using CT imaging. Overall survival rate (OSR) was evaluated from the viewpoints of PHT and MVL. Results: There were no significant differences in clinical background (age, gender, etiology, presence of HCC [within Milan criteria], or Child–Pugh class) between the groups. Although there was no significant difference regarding OSR between patients with and without MVL in the non‐PHT group ( P = 0.076, Holm's method), the OSR of patients with MVL in the PHT group was lower compared to those without MVL in both groups ( P = 0.017 and P = 0.012, respectively, Holm's method). As a result, the OSR of patients with MVL ( n = 54) was lower than the other patients ( n = 292) (3‐ and 5‐year OSR, 69.0% vs. 86.4% and 35.8% vs. 74.1%, respectively; P < 0.001). Multivariate Cox hazard analysis showed that positive for HCC (hazard ratio [HR], 2.028; 95% confidence interval [CI], 1.189–3.460; P = 0.009) and positive for MVL (HR, 2.768; 95% CI, 1.575–4.863; P < 0.001) were significant independent prognostic factors for death. Conclusion: Muscle volume loss and HCC, but not PHT, were found to be independent prognostic factors for death in LC patients.