The Value of CT Imaging and Psoas Muscle Index in Grading the Severity of Sarcopenia in Liver Cirrhosis Patients and its Impact on Morbidity and Mortality
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- Category: Vol. 89, September 2021
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The Value of CT Imaging and Psoas Muscle Index in Grading the Severity of Sarcopenia in Liver Cirrhosis Patients and its Impact on Morbidity and Mortality, HEBA KAMAL and NEVIEN EL-LEITHY
Abstract
Background: Sarcopenia is a common feature of malnu-trition in patient with liver cirrhosis and is widely recognized as independent predictor of poor outcome and mortality in this setting. Aim of Study: This work was conducted to assess the severity of sarcopenia in liver cirrhosis patients, by quantifying muscle mass through CT at L3 level, measuring psoas muscle volume and cross sectional area, than correlating the results with hand grip strength as representative of functional status. Patients and Methods: This study included 101 liver cirrhosis patients and 30 controls. All enrolled subjects had abdominal computed tomographic (CT) imaging at the level of L3 to calculate Psoas muscle cross sectional area, volume, and psoas muscle index (PMI) which is the sum of both RT and LT cross sectional area/height2 (m2), also hand grip strength was calculated for all patients using hand grip dy-namometry. The severity of cirrhosis was classified according to the Child-Pugh and MELD scores. Result: This was an observational prospective study including (101 liver cirrhosis & 30 controls), the mean age was 59.67 ys±8.01, cirrhotic patients were graded into three groups according to Child scoring system. Mean CT psoas volume, psoas surface area and psoas muscle index for Child (A+B) were 25.44±6.96, 7.97±2.23 & 4.58±1.21, while for Child C, were 15.85±6.02, 5.02±1.80 & 2.96±1.00. Using the FNIH (Foundation for the national Institutes of health) cuff off of hand grip (<26kg in male and <16kg in female Psoas muscle index cut off was 4.5cm2/m2. Conclusion: Psoas muscle cross sectional area, volume and index measurements were well correlated with hand grip strength and proved to be independent prognostic factor for grading sarcopenia in cirrhotic patients.