Comparison of Prognostic Impact between the Child-Pugh Score and Skeletal Muscle Mass for Patients with Liver Cirrhosis

Nutrients. 2017 Jun 12;9(6):595. doi: 10.3390/nu9060595.

Abstract

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.

Keywords: Child-Pugh score; bioimpedance analysis; liver cirrhosis; prognosis; skeletal muscle mass index.

MeSH terms

  • Aged
  • Biomarkers
  • Cohort Studies
  • Female
  • Health Status Indicators*
  • Humans
  • Liver Cirrhosis*
  • Male
  • Middle Aged
  • Muscle, Skeletal*
  • Prognosis

Substances

  • Biomarkers