Evaluation of Sarcopenia and Investigation of Prognostic Value Of Sarcopenia Using Psoas Muscle Area on Computed Tomography in Patients with Liver Cirrhosis

Abstract

Objective: To investigate the frequency of sarcopenia in cirrhotic patients, the correlation of sarcopenia with conventional prognostic scores and its relationship with mortality by measuring the psoas muscle area at the level of mid-3rd lumbar (L3) vertebra on computed tomography (CT) scan. Materials and Methods: We included 229 cirrhotic patients who had undergone abdominal CT scan for hepatocellular carcinoma screening. A control group was formed in 204 healthy individuals who had undergone abdominal computed tomography examination due to trauma. 1- and 3-year follow-up results were recorded. Cross-sectional areas of the right and left psoas muscles were calculated in axial sections passing through the level of the mid-L3 in CT images. The cases with two standard deviations under the mean of the total psoas muscle area in control group were evaluated as sarcopenic. Results: Sarcopenia was detected in 39.7% of 229 cirrhotic patients. While a statistically significant difference was detected in the Child-Pugh prognostic score between cirrhotic patients with and without sarcopenia, there was a modest difference in the MELD score. The percentage of cirrhotic patients with sarcopenia who passed during 1- and 3- year follow-ups (28.6% and 40.7%, respectively) were significantly higher than non-sarcopenic patients (9.4% and 24.6%, respectively). Conclusion: The findings obtained in this study suggest that psoas muscle atrophy shown by CT scan image at the level of the mid-L3 vertebra has predictive value for mortality in cirrhotic patients.