Open AccessLow skeletal muscle mass is associated with increased hospital costs in patients with cirrhosis listed for liver transplantation–a retrospective study
Author(s) -
Vugt Jeroen L. A.,
Buettner Stefan,
Alferink Louise J. M.,
Bossche Niek,
de Bruin Ron W. F.,
Darwish Murad Sarwa,
Polak Wojciech G.,
Metselaar Herold J.,
IJzermans Jan N. M.
Publication year - 2018
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13048
Subject(s) - sarcopenia , medicine , liver transplantation , quartile , cirrhosis , body mass index , retrospective cohort study , transplantation , skeletal muscle , surgery , gastroenterology , confidence interval
Summary Low skeletal muscle mass (sarcopenia) is associated with increased morbidity and mortality in liver transplant candidates. We investigated the association between sarcopenia and hospital costs in patients listed for liver transplantation. Consecutive patients with cirrhosis listed for liver transplantation between 2007 and 2014 in a Eurotransplant centre were identified. The skeletal muscle index ( SMI , cm 2 /m 2 ) was measured on CT performed within 90 days from waiting list placement. The lowest sex‐spe cific quartile represented patients with sarcopenia. In total, 224 patients were included. Median time on the waiting list was 170 ( IQR 47–306) days, and median MELD score was 16 ( IQR 11–20). The median total hospital costs in patients with sarcopenia were €11 294 ( IQR 3570–46 469) compared with €6878 ( IQR 1305–20 683) in patients without sarcopenia ( P = 0.008). In multivariable regression analysis, an incremental increase in SMI was significantly associated with a decrease in total costs (€455 per incremental SMI , 95% CI 11–900, P = 0.045), independent of the total time on the waiting list. In conclusion, sarcopenia is independently associated with increased health‐related costs for patients on the waiting list for liver transplantation. Optimizing skeletal muscle mass may therefore lead to a decrease in hospital expenditure, in addition to greater health benefit for the transplant candidate.