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Muscle volume loss a prognostic factor for death in liver cirrhosis patients and special relationship to portal hypertension.
- Source :
-
Hepatology research : the official journal of the Japan Society of Hepatology [Hepatol Res] 2018 Feb; Vol. 48 (3), pp. E354-E359. Date of Electronic Publication: 2017 Oct 18. - Publication Year :
- 2018
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Abstract
- Aim: We examined the prognosis of liver cirrhosis (LC) patients with and without portal hypertension (PHT) and muscle volume loss (MVL).<br />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.<br />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.<br />Conclusion: Muscle volume loss and HCC, but not PHT, were found to be independent prognostic factors for death in LC patients.<br /> (© 2017 The Japan Society of Hepatology.)
Details
- Language :
- English
- ISSN :
- 1386-6346
- Volume :
- 48
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Hepatology research : the official journal of the Japan Society of Hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 28940597
- Full Text :
- https://doi.org/10.1111/hepr.12984