Montano-Loza et al evaluated the impact of sarcopenic obesity and myosteatosis on mortality of a patient with cirrhosis. These findings can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Alberta, University of Kentucky, Cross Cancer Institute (Edmonton) and Food and Nutritional Sciences (Edmonton).
Patient selection: cirrhosis
Analysis: CT at L3, with skeletal muscle index (square cm per square meter) and mean muscle attenuation (HU)
Predictors of mortality from the multivariate analysis:
(1) sarcopenia (HR 2.0)
(2) myosteatosis (HR 1.4)
(3) MELD score (HR 1.04 per point; score > 15 based on Table 3)
(4) NASH-cryptogenic cirrhosis (HR 0.6)
Sarcopenic obesity is viewed as a subset of sarcopenia. Median overall survival was 22 months with vs 95 months without.
The increased risk of mortality is associated with greater risk of sepsis.
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