Impact of sarcopenia on variceal rebleeding in patients after endoscopic therapy: a multicenter retrospective cohort study based on propensity score matching

Ann Med. 2024 Dec;56(1):2349180. doi: 10.1080/07853890.2024.2349180. Epub 2024 May 3.

Abstract

Background: Sarcopenia is a common complication of liver cirrhosis and can be used for predicting dismal prognostic outcomes. This study aimed to evaluate the role of sarcopenia in rebleeding and mortality of liver cirrhosis patients after endoscopic therapy.

Methods: The liver cirrhosis patients who received endoscopic treatment were enrolled. Propensity score matching (PSM) was used to overcome selection bias. Two-year rebleeding episodes and mortality after endoscopic therapy were recorded.

Results: A total of 109 (32.4%) sarcopenia patients were reported. Before PSM, the frequency of rebleeding was significantly higher in the sarcopenia group relative to the non-sarcopenia group (41.3% vs. 15.9%, p < 0.001). Moreover, the multivariable analysis revealed that sarcopenia (p < 0.001, HR:2.596, 95% CI 1.591-4.237) was independently associated with a 2-year rebleeding episode. After PSM, the sarcopenia group exhibited an increased rebleeding rate as compared with non-sarcopenia group (44.4% vs. 15.3%, p < 0.001). According to multivariable analysis, sarcopenia (p < 0.001, HR:3.490, 95% CI 1.756-6.938) was identified as a significant predictor for 2-year rebleeding.

Conclusion: Sarcopenia was significantly associated with a high 2-year rebleeding rate in liver cirrhosis patients after endoscopic treatment. Therefore, the precise evaluation of a patient's nutritional status, including sarcopenia becomes mandatory before endoscopic treatment.

Keywords: Liver cirrhosis; endoscopic therapy; rebleeding; sarcopenia.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Esophageal and Gastric Varices* / etiology
  • Female
  • Gastrointestinal Hemorrhage* / etiology
  • Humans
  • Liver Cirrhosis* / complications
  • Male
  • Middle Aged
  • Prognosis
  • Propensity Score*
  • Recurrence*
  • Retrospective Studies
  • Risk Factors
  • Sarcopenia* / complications
  • Sarcopenia* / epidemiology
  • Sarcopenia* / etiology

Grants and funding

This work was supported by the National Key Research and Development Program of China (Grant No. 2023YFC2507500) and the Grant from Shandong University (Grant No. 2021SDUCRCB005).