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Muscle volume loss a prognostic factor for death in liver cirrhosis patients and special relationship to portal hypertension
Author(s) -
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
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12984
Subject(s) - medicine , gastroenterology , hepatocellular carcinoma , cirrhosis , hazard ratio , portal hypertension , confidence interval
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.