Improvement of sarcopenia is beneficial for prognosis in cirrhotic patients after TIPS placement

Abstract

Background: The relationship between the improvement of sarcopenia and post-TIPS prognosis has not been fully investigated.

Aims: To assess what level of sarcopenia improvement is required for potential benefits to post-TIPS prognosis.

Methods: In this retrospective study, 109 cirrhotic patients with sarcopenia who underwent TIPS between February 2016 and January 2021 were included. The change in skeletal muscle index (SMI) at 6 months post-TIPS was assessed and the correlations of SMI improvement with clinical outcomes were analyzed.

Results: During follow up, 59 (65.6%) patients reversed from sarcopenic to non-sarcopenic, and the cumulative mortality (8.5 % vs. 26.0%, log rank P = 0.013) and incidence of overt hepatic encephalopathy (OHE) (18.6% vs. 44.0%, log rank P = 0.004) in patients who reversed were significantly lower than who did not. SMI improvement rate was identified as an independent risk factor for mortality and OHE. In addition, the cumulative survival rate of patients with sarcopenia reversal or SMI improvement rate > 10.4% was significantly higher than that of patients with an SMI improvement rate ≤ 10.4% (92.5% vs. 58.6%, log rank P < 0.001).

Conclusion: Reversal of sarcopenia or significant SMI improvement by TIPS could reduce the risk of death and OHE.

Keywords: Cirrhosis; Hepatic encephalopathy; Sarcopenia; Survival; Transjugular intrahepatic portosystemic shunt.