Abstract
Psoas Muscle Index as a reliable prognostic marker for Mortality in Decompensated Liver Cirrhosis
Jose Luis Matthias Z. Sollano III, MD; Jessie Jake M. Perlas, MD; Angelo B. Lozada, MD; Jeffrey L. Tantianpact, MD
Makati Medical Center
Significance: Liver cirrhosis, particularly in its decompensated state, poses significant mortality risks globally, necessitating accurate prognostic tools. Established metrics like the MELD and Child-Pugh scores have limitations in predicting short-term mortality. Sarcopenia, being an established complication of Cirrhosis, can be reflected by the Psoas Muscle Index (PMI), has emerged as a potential marker for mortality in liver disease. This study aims to evaluate PMI’s reliability as a prognostic marker for 30-day mortality in patients with decompensated liver cirrhosis.
Methodology: A 5-year retrospective, observational, cohort, analytic study was conducted at a tertiary hospital. Patients aged 18 and above with confirmed decompensated liver cirrhosis and available CT or MRI scans were included. Those with confounding conditions affecting muscle mass were excluded. PMI, along with demographic and clinical data, were analyzed. Mortality within 30 days of admission was the primary outcome. Statistical analysis employed STATA v15, with logistic regression and ROC curve analysis to determine associations and PMI cutoff values.
Results: Among 48 patients, mortality was 37.5%. Decreased PMI scores were significantly associated with higher mortality (p=0.001). PMI showed high sensitivity (88.89%) but low specificity (33.33%) in predicting mortality. Child-Pugh scores demonstrated superior overall diagnostic accuracy compared to PMI and MELD.
Conclusion: PMI is a sensitive but nonspecific marker for short-term mortality in decompensated liver cirrhosis, warranting its integration as a supplementary tool alongside established scores. Limitations include the small sample size and single-center design. Future studies should validate findings in larger cohorts.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |