Title: SARCOPENIA AND FRAILTY IN ADVANCED LIVER DISEASE

Abstract:

SARCOPENIA AND FRAILTY IN ADVANCED LIVER DISEASE

ABSTRACT

Background & Aims: It is important that malnutrition associated with the progression of liver failure be recognized quickly, because it plays an important role in the evolution, the prognosis of patients with advanced liver disease. Severe malnutrition also plays an important role in susceptibility to the development of infections, hepatic encephalopathy, ascites and also as an independent predictor of lower survival in cirrhosis and in patients undergoing liver transplantation. The aim of the study was to establish similarities or differences between sarcopenia and frailty in patients with advanced liver disease in an Emergency Hospital in Bucharest.

Results: We included in the study 159 patients with advanced liver disease, 22% (35 patients) of them had compensated disease and 55.34% (88 patients) had decompensated liver disease. During the study, data on age, body mass index (BMI), weight loss (BW), declining skeletal muscle function, self-reported exhaustion, low physical activity, and low walking speed (WS) were collected. Sarcopenia was identified in 28.30% of cases (45 patients) and fragility in 22% of cases (35 patients). The prevalence of sarcopenia and fragility was well stratified according to age and stage of liver disease. In the multivariate analysis, significant factors for sarcopenia were identified such as age, stage of cirrhosis according to Child-Pugh class, body mass index, and extracellular water ratio (ECW) to total body water (TBW), while for frailty only the ECW / TBW ratio was significant.

Conclusion: Sarcopenia and fragility must be quickly recognized by the clinician as a complication of advanced liver disease and with an important role in the prognosis of these patients.