Affiliation:
1. Department of Dietetics Leiden University Medical Center Leiden the Netherlands
2. Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam the Netherlands
3. Department of Gastroenterology and Hepatology, LUMC Transplantation Center Leiden University Medical Center Leiden the Netherlands
Abstract
AbstractBackgroundLiver transplantation is the only curative therapy for end‐stage liver disease (ESLD). Sarcopenia is often defined as the loss of muscle quantity (skeletal muscle index [SMI]), but muscle attenuation (MA), a surrogate marker of muscle quality, is also decreased in ESLD. We assessed pre–liver transplant SMI and MA and their association with posttransplant mortality, complications, and length of intensive care unit (ICU) and hospital stay.MethodsIn 169 consecutive patients with ESLD who underwent a liver transplantation between 2007 and 2014, SMI and MA were measured on computed tomography scans at time of placement on the waiting list for liver transplantation. The primary outcome of interest was 1‐year posttransplant mortality. Secondary posttransplantation outcomes of interest were complications within 30 days and length of stay in the ICU > 3 days and in the hospital >3 weeks. Logistic and Cox regression analyses were performed.ResultsMA was associated with 1‐year posttransplant mortality rate (hazard ratio=0.656, 95% CI=0.464–0.921, P = 0.015). The highest quartile of SMI had a lower odds for the total length of stay in the hospital lasting >3 weeks (odds ratio=0.211, 95% CI=0.061–0.733, P = 0.014). MA was associated with a prolonged ICU stay; this was, however, not statistically significant after adjustment for age, sex, and Model for ESLD score.ConclusionLower MA is associated with a longer length of ICU stay and 1‐year mortality after liver transplantation, whereas low SMI was associated with a total length of hospital stay.
Subject
Nutrition and Dietetics,Medicine (miscellaneous)