Comparison of Prognostic Impact between the Child-Pugh Score and Skeletal Muscle Mass for Patients with Liver Cirrhosis
2017
Hiroki Nishikawa | Hirayuki Enomoto | Akio Ishii | Yoshinori Iwata | Yuho Miyamoto | Noriko Ishii | Yukihisa Yuri | Kunihiro Hasegawa | Chikage Nakano | Takashi Nishimura | Kazunori Yoh | Nobuhiro Aizawa | Yoshiyuki Sakai | Naoto Ikeda | Tomoyuki Takashima | Ryo Takata | Hiroko Iijima | Shuhei Nishiguchi
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.
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