Durand et al measured sarcopenia in patients with cirrhosis. The ratio of the psoas muscle thickness in a CT scan to height is associated with prognosis. The authors are from Hospital Beaujon, Hospital Bichat, and Universite Paris Diderot in France.
Patient selection: cirrhosis
Analysis: CT scan at the level of the umbilicus; axial thickness of psoas was in AP axis with transverse measure perpendicular (parallel to exam table)
Measurements:
(1) transverse psoas muscle thickness (TPMT) in mm at the level of the umbilicus
(2) body height in meters
TPMT to height ratio =
= (TPMT in mm) / (height in meters)
Interpretation:
• A ratio from 27 to 32 was associated with a neglible relative risk of death.
• A decline in the ratio was associated with increased mortality.
• In patients with refractory ascites a ration < 16.8 was associated with significant mortality.
• The ratio can be used in conjunction with MELD and MELD-Na.
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