Myosteatosis Is Associated With Frailty and Poor Physical Function in Patients Undergoing Liver Transplant Evaluation: A Cohort Study
Myosteatosis is fat infiltration within skeletal muscle. The impact of myosteatosis on physical function and clinical outcomes in patients referred for liver transplantation (LT) is unclear. We explored associations between myosteatosis and sarcopenia, frailty, physical function, and pre- and early...
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| Veröffentlicht in: | Clinical transplantation 2024-12, Vol.38 (12), p.e70034 |
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| creator | Johnston, Heidi E Andelkovic, Melita Mayr, Hannah L Chen, Yanyan Thrift, Aaron P Macdonald, Graeme A Hickman, Ingrid J |
| description | Myosteatosis is fat infiltration within skeletal muscle. The impact of myosteatosis on physical function and clinical outcomes in patients referred for liver transplantation (LT) is unclear. We explored associations between myosteatosis and sarcopenia, frailty, physical function, and pre- and early post-LT outcomes.
Myosteatosis was assessed by computed tomography (CT) in 237 patients referred for LT (March 2018 to September 2022). Chi-square/Fishers exact tests and multivariable regression compared myosteatosis and sarcopenia, frailty (liver frailty index), physical function (short physical performance battery, SPPB); and associations with pre-LT unplanned hospitalizations, post-LT surgical complications (Clavien-Dindo grade ≥ 3), and LT admission length of stay (LOS). Kaplan-Meier and Cox-proportional hazards models explored myosteatosis and time to LT and unplanned admission. Fine-Gray model evaluated the competing risks of receiving an LT.
Myosteatosis was present in 74 (31%) patients. Patients with myosteatosis were 2.5 times (95% confidence interval [CI] 1.1-5.7, p = 0.03) more likely to be frail, and 3.0 times (95% CI 1.6-5.6, p |
| doi_str_mv | 10.1111/ctr.70034 |
| format | Article |
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Myosteatosis was assessed by computed tomography (CT) in 237 patients referred for LT (March 2018 to September 2022). Chi-square/Fishers exact tests and multivariable regression compared myosteatosis and sarcopenia, frailty (liver frailty index), physical function (short physical performance battery, SPPB); and associations with pre-LT unplanned hospitalizations, post-LT surgical complications (Clavien-Dindo grade ≥ 3), and LT admission length of stay (LOS). Kaplan-Meier and Cox-proportional hazards models explored myosteatosis and time to LT and unplanned admission. Fine-Gray model evaluated the competing risks of receiving an LT.
Myosteatosis was present in 74 (31%) patients. Patients with myosteatosis were 2.5 times (95% confidence interval [CI] 1.1-5.7, p = 0.03) more likely to be frail, and 3.0 times (95% CI 1.6-5.6, p < 0.001) more likely to have a poor physical function (SPPB ≤ 9/12) than those without myosteatosis. Patients with myosteatosis versus those without were more likely to have a pre-LT unplanned hospitalization (51% vs. 36%, p = 0.03), but significance was lost after adjusting for age, sex, Model for End-stage Liver Disease (MELD), and the presence of hepatocellular carcinoma. Myosteatosis did not impact the likelihood of receiving an LT (p = 0.39), post-LT complications (p = 0.93), or LOS in intensive care unit (ICU) (p = 0.66) or hospital (p = 0.34).
Myosteatosis is prevalent in patients referred for LT and is associated with impaired physical function. Using existing CTs to assess myosteatosis in practice may help identify physically compromised patients.</description><identifier>ISSN: 1399-0012</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.70034</identifier><identifier>PMID: 39624939</identifier><language>eng</language><publisher>Denmark</publisher><subject>Aged ; End Stage Liver Disease - complications ; End Stage Liver Disease - surgery ; Female ; Follow-Up Studies ; Frailty - complications ; Humans ; Liver Transplantation - adverse effects ; Male ; Middle Aged ; Muscle, Skeletal ; Muscular Diseases - etiology ; Postoperative Complications - etiology ; Prognosis ; Retrospective Studies ; Risk Factors ; Sarcopenia - diagnosis ; Sarcopenia - etiology</subject><ispartof>Clinical transplantation, 2024-12, Vol.38 (12), p.e70034</ispartof><rights>2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-6050-8381 ; 0000-0001-7356-653X ; 0000-0002-0084-5308 ; 0000-0003-3205-9165 ; 0000-0003-0929-110X ; 0009-0008-5063-8447 ; 0000-0001-5332-6520</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39624939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnston, Heidi E</creatorcontrib><creatorcontrib>Andelkovic, Melita</creatorcontrib><creatorcontrib>Mayr, Hannah L</creatorcontrib><creatorcontrib>Chen, Yanyan</creatorcontrib><creatorcontrib>Thrift, Aaron P</creatorcontrib><creatorcontrib>Macdonald, Graeme A</creatorcontrib><creatorcontrib>Hickman, Ingrid J</creatorcontrib><title>Myosteatosis Is Associated With Frailty and Poor Physical Function in Patients Undergoing Liver Transplant Evaluation: A Cohort Study</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>Myosteatosis is fat infiltration within skeletal muscle. The impact of myosteatosis on physical function and clinical outcomes in patients referred for liver transplantation (LT) is unclear. We explored associations between myosteatosis and sarcopenia, frailty, physical function, and pre- and early post-LT outcomes.
Myosteatosis was assessed by computed tomography (CT) in 237 patients referred for LT (March 2018 to September 2022). Chi-square/Fishers exact tests and multivariable regression compared myosteatosis and sarcopenia, frailty (liver frailty index), physical function (short physical performance battery, SPPB); and associations with pre-LT unplanned hospitalizations, post-LT surgical complications (Clavien-Dindo grade ≥ 3), and LT admission length of stay (LOS). Kaplan-Meier and Cox-proportional hazards models explored myosteatosis and time to LT and unplanned admission. Fine-Gray model evaluated the competing risks of receiving an LT.
Myosteatosis was present in 74 (31%) patients. Patients with myosteatosis were 2.5 times (95% confidence interval [CI] 1.1-5.7, p = 0.03) more likely to be frail, and 3.0 times (95% CI 1.6-5.6, p < 0.001) more likely to have a poor physical function (SPPB ≤ 9/12) than those without myosteatosis. Patients with myosteatosis versus those without were more likely to have a pre-LT unplanned hospitalization (51% vs. 36%, p = 0.03), but significance was lost after adjusting for age, sex, Model for End-stage Liver Disease (MELD), and the presence of hepatocellular carcinoma. Myosteatosis did not impact the likelihood of receiving an LT (p = 0.39), post-LT complications (p = 0.93), or LOS in intensive care unit (ICU) (p = 0.66) or hospital (p = 0.34).
Myosteatosis is prevalent in patients referred for LT and is associated with impaired physical function. Using existing CTs to assess myosteatosis in practice may help identify physically compromised patients.</description><subject>Aged</subject><subject>End Stage Liver Disease - complications</subject><subject>End Stage Liver Disease - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Frailty - complications</subject><subject>Humans</subject><subject>Liver Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal</subject><subject>Muscular Diseases - etiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sarcopenia - diagnosis</subject><subject>Sarcopenia - etiology</subject><issn>1399-0012</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkM1OAjEUhRujEUUXvoC5SzeD078Z644QUBKMJEJckk5boGZose2QzAP43o4RE-_mfotzT-45CN3gfIC7uVcpDMo8p-wEXWAqRJbnmJz-4x66jPGjowIX_Bz1qCgIE1RcoK-X1sdkZPLRRphGGMbolZXJaHi3aQuTIG2dWpBOw9z7APNtG62SNUwap5L1DqyDuUzWuBRh6bQJG2_dBmb2YAIsgnRxX0uXYHyQdSN_Th5hCCO_9SHBW2p0e4XO1rKO5vq4-2g5GS9Gz9ns9Wk6Gs6yPWY4ZUJhyTWpOCsZ74LTvBCKUM54ySpCCkOkUnit2AMWVBvMja7U2mBclWsmS0376O7Xdx_8Z2NiWu1sVKbu3jO-iSuKWS4IJ5x20tujtKl2Rq_2we5kaFd_1dFvIAdxIw</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Johnston, Heidi E</creator><creator>Andelkovic, Melita</creator><creator>Mayr, Hannah L</creator><creator>Chen, Yanyan</creator><creator>Thrift, Aaron P</creator><creator>Macdonald, Graeme A</creator><creator>Hickman, Ingrid J</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6050-8381</orcidid><orcidid>https://orcid.org/0000-0001-7356-653X</orcidid><orcidid>https://orcid.org/0000-0002-0084-5308</orcidid><orcidid>https://orcid.org/0000-0003-3205-9165</orcidid><orcidid>https://orcid.org/0000-0003-0929-110X</orcidid><orcidid>https://orcid.org/0009-0008-5063-8447</orcidid><orcidid>https://orcid.org/0000-0001-5332-6520</orcidid></search><sort><creationdate>202412</creationdate><title>Myosteatosis Is Associated With Frailty and Poor Physical Function in Patients Undergoing Liver Transplant Evaluation: A Cohort Study</title><author>Johnston, Heidi E ; Andelkovic, Melita ; Mayr, Hannah L ; Chen, Yanyan ; Thrift, Aaron P ; Macdonald, Graeme A ; Hickman, Ingrid J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p141t-9c1a5d2b547451113069c2354574b226e2acc1fc48193de15edbcfe11b7f4a7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>End Stage Liver Disease - complications</topic><topic>End Stage Liver Disease - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Frailty - complications</topic><topic>Humans</topic><topic>Liver Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal</topic><topic>Muscular Diseases - etiology</topic><topic>Postoperative Complications - etiology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sarcopenia - diagnosis</topic><topic>Sarcopenia - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnston, Heidi E</creatorcontrib><creatorcontrib>Andelkovic, Melita</creatorcontrib><creatorcontrib>Mayr, Hannah L</creatorcontrib><creatorcontrib>Chen, Yanyan</creatorcontrib><creatorcontrib>Thrift, Aaron P</creatorcontrib><creatorcontrib>Macdonald, Graeme A</creatorcontrib><creatorcontrib>Hickman, Ingrid J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnston, Heidi E</au><au>Andelkovic, Melita</au><au>Mayr, Hannah L</au><au>Chen, Yanyan</au><au>Thrift, Aaron P</au><au>Macdonald, Graeme A</au><au>Hickman, Ingrid J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myosteatosis Is Associated With Frailty and Poor Physical Function in Patients Undergoing Liver Transplant Evaluation: A Cohort Study</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2024-12</date><risdate>2024</risdate><volume>38</volume><issue>12</issue><spage>e70034</spage><pages>e70034-</pages><issn>1399-0012</issn><eissn>1399-0012</eissn><abstract>Myosteatosis is fat infiltration within skeletal muscle. The impact of myosteatosis on physical function and clinical outcomes in patients referred for liver transplantation (LT) is unclear. We explored associations between myosteatosis and sarcopenia, frailty, physical function, and pre- and early post-LT outcomes.
Myosteatosis was assessed by computed tomography (CT) in 237 patients referred for LT (March 2018 to September 2022). Chi-square/Fishers exact tests and multivariable regression compared myosteatosis and sarcopenia, frailty (liver frailty index), physical function (short physical performance battery, SPPB); and associations with pre-LT unplanned hospitalizations, post-LT surgical complications (Clavien-Dindo grade ≥ 3), and LT admission length of stay (LOS). Kaplan-Meier and Cox-proportional hazards models explored myosteatosis and time to LT and unplanned admission. Fine-Gray model evaluated the competing risks of receiving an LT.
Myosteatosis was present in 74 (31%) patients. Patients with myosteatosis were 2.5 times (95% confidence interval [CI] 1.1-5.7, p = 0.03) more likely to be frail, and 3.0 times (95% CI 1.6-5.6, p < 0.001) more likely to have a poor physical function (SPPB ≤ 9/12) than those without myosteatosis. Patients with myosteatosis versus those without were more likely to have a pre-LT unplanned hospitalization (51% vs. 36%, p = 0.03), but significance was lost after adjusting for age, sex, Model for End-stage Liver Disease (MELD), and the presence of hepatocellular carcinoma. Myosteatosis did not impact the likelihood of receiving an LT (p = 0.39), post-LT complications (p = 0.93), or LOS in intensive care unit (ICU) (p = 0.66) or hospital (p = 0.34).
Myosteatosis is prevalent in patients referred for LT and is associated with impaired physical function. Using existing CTs to assess myosteatosis in practice may help identify physically compromised patients.</abstract><cop>Denmark</cop><pmid>39624939</pmid><doi>10.1111/ctr.70034</doi><orcidid>https://orcid.org/0000-0001-6050-8381</orcidid><orcidid>https://orcid.org/0000-0001-7356-653X</orcidid><orcidid>https://orcid.org/0000-0002-0084-5308</orcidid><orcidid>https://orcid.org/0000-0003-3205-9165</orcidid><orcidid>https://orcid.org/0000-0003-0929-110X</orcidid><orcidid>https://orcid.org/0009-0008-5063-8447</orcidid><orcidid>https://orcid.org/0000-0001-5332-6520</orcidid></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Aged End Stage Liver Disease - complications End Stage Liver Disease - surgery Female Follow-Up Studies Frailty - complications Humans Liver Transplantation - adverse effects Male Middle Aged Muscle, Skeletal Muscular Diseases - etiology Postoperative Complications - etiology Prognosis Retrospective Studies Risk Factors Sarcopenia - diagnosis Sarcopenia - etiology |
| title | Myosteatosis Is Associated With Frailty and Poor Physical Function in Patients Undergoing Liver Transplant Evaluation: A Cohort Study |
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