Aims and objectives
Cirrhosis is associated with loss of muscle mass and these changes are associated with increased mortality.
The study examined the role of pre-TIPS psoas muscle density (PD) measurement in predicting survival when combined with model of end-stage liver disease (MELD) score.
Methods and materials
We retrospectively reviewed the medical records of 287 patients who had TIPS from June 2005 and June 2015.
PD was measured in Hounsfield Units (HU) by creating a region of interest on the whole psoas muscle on a non-contrast CT prior to TIPS (Fig. 1).
Pre-TIPS MELD score was calculated.
The primary endpoint was to determine a threshold sensitivity of pre-TIPS PD for assessing mortality and measure its correlation with post-TIPS survival.
The secondary endpoint was to determine if combining the PD threshold with MELD...
Results
The study included 175 (62%) males,
253 (88%) Caucasians,
age 56 years (SD=9.8),
with average pre-TIPS MELD score of 12.4 (SD=7.5) ( Table 1 ).
The threshold of pre-TIPS PD for discriminating survival was 29.42 HU (p=00026).
PD below these thresholds was associated with higher risk of mortality.
Compared to using MELD alone,
adding PD measurement significantly increased the survival predictability with higher AUC for MELD score combined with PD (0.643)compared to MELD score alone (0.587)(p=0.0022) ( Fig. 2 ).
A higher pre-TIPS PD was...
Conclusion
When used in conjunction with MELD score,
PD improves overall survival predictability of cirrhotic patients undergoing TIPS.
The best survival outcome was reported in patients with MELD score <15 and PD>29.42 HU.
Personal information
Ahmed KamelAbdel Aal ,
MD,PhD,
FSIR
University of Alabama at Birmingham (UAB).
Department of Radiology
Division ofInterventional Radiology.
United States ,
Alabama.
Address: 619 19th Street South,
Birmingham,
AL 35249.
Tel:(205) 975-4850
Fax: (205) 975-5257.
Email:
[email protected]
Twitter: ahmed_kamel_ir
References
Valero V 3rd,
Amini N,Spolverato G,
et al.
J Gastrointest Surg.
2015 February.
Sarcopenia Adversely Impacts Postoperative Complications Following Resection or Transplantation in Patients with Primary Liver Tumors.