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Relative Sarcopenia With Excess Adiposity Predicts Survival After Transjugular Intrahepatic Portosystemic Shunt Creation.

Publication ,  Journal Article
Ronald, J; Bozdogan, E; Zaki, IH; Kappus, MR; Choi, SS; Martin, JG; Suhocki, PV; Smith, TP; Kim, CY; Bashir, MR
Published in: AJR Am J Roentgenol
January 2020

OBJECTIVE. The purpose of this study was to assess the impact of relative sarcopenia with excess adiposity on mortality after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS. In this single-institution retrospective study, patients underwent abdominal CT scans within 100 days before or 30 days after TIPS creation. Subcutaneous and visceral adipose tissue and muscle were segmented at the L3 vertebral level. Relative sarcopenia with excess adiposity was defined as the lowest sex-specific quartile of muscle area divided by muscle plus adipose. Dates of death, liver transplantation, TIPS occlusion, and hepatic encephalopathy (HE) after TIPS creation were identified. Mortality was evaluated using competing risks survival analysis. Number of HE episodes and time to first episode were analyzed using negative binomial regression and competing risks survival analysis, respectively. RESULTS. A total of 141 patients (91 men; mean age, 56 years) were included in this study. In univariate analyses, Model for End-Stage Liver Disease (MELD) score (hazard ratio [HR], 1.09 per point; CI, 1.05-1.13; p < 0.001) and relative sarcopenia with excess adiposity (HR, 2.70; CI, 1.55-4.69; p < 0.001) were significant risk factors for shorter survival after TIPS. In multivariate analysis, both MELD score (HR, 1.09; CI, 1.03-1.15; p = 0.003) and relative sarcopenia with excess adiposity (HR, 2.65; CI, 1.56-4.51; p < 0.001) were significant predictors of worse survival. The C-index at 30 days was 0.71 for MELD score, 0.72 for relative sarcopenia with excess adiposity, and 0.80 for a model including both. There was no association between relative sarcopenia with excess adiposity and number of HE episodes (incidence rate ratio, 1.08; CI, 0.49-2.40; p = 0.84) or time to first HE episode (HR, 0.89; CI, 0.51-1.54; p = 0.67). CONCLUSION. Relative sarcopenia with excess adiposity is a risk factor for mortality after TIPS and contributes additional prognostic information beyond MELD score.

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Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

January 2020

Volume

214

Issue

1

Start / End Page

200 / 205

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Sarcopenia
  • Risk Factors
  • Retrospective Studies
  • Prognosis
  • Postoperative Complications
  • Portasystemic Shunt, Transjugular Intrahepatic
  • Obesity
  • Nuclear Medicine & Medical Imaging
 

Citation

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Ronald, J., Bozdogan, E., Zaki, I. H., Kappus, M. R., Choi, S. S., Martin, J. G., … Bashir, M. R. (2020). Relative Sarcopenia With Excess Adiposity Predicts Survival After Transjugular Intrahepatic Portosystemic Shunt Creation. AJR Am J Roentgenol, 214(1), 200–205. https://doi.org/10.2214/AJR.19.21655
Ronald, James, Erol Bozdogan, Islam H. Zaki, Matthew R. Kappus, Steven S. Choi, Jonathan G. Martin, Paul V. Suhocki, Tony P. Smith, Charles Y. Kim, and Mustafa R. Bashir. “Relative Sarcopenia With Excess Adiposity Predicts Survival After Transjugular Intrahepatic Portosystemic Shunt Creation.AJR Am J Roentgenol 214, no. 1 (January 2020): 200–205. https://doi.org/10.2214/AJR.19.21655.
Ronald J, Bozdogan E, Zaki IH, Kappus MR, Choi SS, Martin JG, et al. Relative Sarcopenia With Excess Adiposity Predicts Survival After Transjugular Intrahepatic Portosystemic Shunt Creation. AJR Am J Roentgenol. 2020 Jan;214(1):200–5.
Ronald, James, et al. “Relative Sarcopenia With Excess Adiposity Predicts Survival After Transjugular Intrahepatic Portosystemic Shunt Creation.AJR Am J Roentgenol, vol. 214, no. 1, Jan. 2020, pp. 200–05. Pubmed, doi:10.2214/AJR.19.21655.
Ronald J, Bozdogan E, Zaki IH, Kappus MR, Choi SS, Martin JG, Suhocki PV, Smith TP, Kim CY, Bashir MR. Relative Sarcopenia With Excess Adiposity Predicts Survival After Transjugular Intrahepatic Portosystemic Shunt Creation. AJR Am J Roentgenol. 2020 Jan;214(1):200–205.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

January 2020

Volume

214

Issue

1

Start / End Page

200 / 205

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Sarcopenia
  • Risk Factors
  • Retrospective Studies
  • Prognosis
  • Postoperative Complications
  • Portasystemic Shunt, Transjugular Intrahepatic
  • Obesity
  • Nuclear Medicine & Medical Imaging