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Comparison of Prognostic Impact between the Child-Pugh Score and Skeletal Muscle Mass for Patients with Liver Cirrhosis

Nishikawa, Hiroki, Enomoto, Hirayuki, Ishii, Akio, Iwata, Yoshinori, Miyamoto, Yuho, Ishii, Noriko, Yuri, Yukihisa, Hasegawa, Kunihiro, Nakano, Chikage, Nishimura, Takashi, Yoh, Kazunori, Aizawa, Nobuhiro, Sakai, Yoshiyuki, Ikeda, Naoto, Takashima, Tomoyuki, Takata, Ryo, Iijima, Hiroko, Nishiguchi, Shuhei
Nutrients 2017 v.9 no.6
bioelectrical impedance, females, liver cirrhosis, males, multivariate analysis, patients, prediction, skeletal muscle
Aims: To investigate the influence of skeletal muscle mass index (SMI) as determined by bioimpedance analysis (BIA) (appendicular skeletal muscle mass/(height)2) on survival by comparing the Child-Pugh score in patients with liver cirrhosis (LC, n = 383, average age = 65.2 years). Patients and methods: In terms of comparison of the effects of SMI and other markers on survival, we used time-dependent receiver operating characteristics (ROC) analysis. Results: The average SMI for male was 7.4 cm2/m2 whereas that for female was 6.0 cm2/m2 (p < 0.0001). As for the Child-Pugh score, five points were in the majority, both in males (51.7%, (106/205)) and females (44.9%, (80/178)). For both genders, the survival curve was well stratified according to SMI (p < 0.0001 for males and p = 0.0056 for females). In the multivariate analysis for survival, SMI and Child-Pugh scores were found to be significant both in males and females. In time-dependent ROC analyses, all area under the ROCs (AUROCs) for SMI in each time point were higher than those for Child-Pugh scores in males, while in females AUROCs for Child-Pugh scores at each time point were higher than those for SMI. Conclusion: SMI using BIA can be helpful for predicting outcomes, at least in male LC patients.