A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index

BMC Gastroenterology

Research

Xiaoxiao Liang¹  Yuan Liu²  Jingjing Zhang³  Ning Zhang³  Chao Zhou³  Jin Zhang³  Tianyi Zhang³  Shuangnan Fu³  Xin Li³  Man Gong³  Tingting He³  Pengcheng Liu³ 

[1] Beijing Chaoyang Integrative Medicine Emergency Center, Beijing, China;Department of Diagnostic Radiology, 5th Medical Center of Chinese PLA General Hospital, No. 100, the 4th Ring Road, Beijing, China;Department of Liver Disease, 5th Medical Center of Chinese PLA General Hospital, No. 100, the 4th Ring Road, Beijing, China;

关键词: Erector spine mass;    Prognosis;    Liver Failure;    Hepatic encephalopathy;    Kidney dysfunction;   

DOI  :  10.1186/s12876-023-02995-x

 received in 2023-05-15, accepted in 2023-10-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIt is widely known that muscle mass influences the outcomes of many chronic diseases. Erector spine mass is a convenient parameter obtained from routine abdominal computed tomography (CT). The clinical application value of erector spine mass, and whether erector spine mass could predict the outcome of disease has not been studied.AimTo evaluate the role of the erector spine index (ESI) calculated based on abdominal CT imaging in the progression of acute-on-chronic liver failure related to the hepatitis B virus (HBV-ACLF).MethodsWe performed a retrospective study of 118 HBV-ACLF patients and calculated the ESI (the total erector spine area normalized for height2 in meters) for each patient through abdominal CT. The findings were analyzed regarding the progression of HBV-ACLF and the ESI at baseline, including mortality and the development of complications.ResultsThe ESI level was associated with mortality and the development of complications. During the 90-day follow-up period, patients with a low ESI (<12.05 cm2/m2) had higher mortality than those with a high ESI (≥ 12.05 cm2/m2) (51.7% vs. 26.7%), and the cumulative survival rates were 71.0%±4.6 and 85.8%±3.9, respectively (log-rank P = 0.003). The hazard ratios (HRs) calculated using univariable and multivariable analyses were 2.23(95% confidence interval (CI): 1.25–4.21, P = 0.005) and 2.52 (95% CI: 1.34–9.24, P = 0.011), respectively. Patients with a low ESI (<12.05 cm2/m2) had higher incidences of kidney dysfunction (43.5% vs. 23.2%, P = 0.029; log-rank P = 0.017) and hepatic encephalopathy (39.6% vs. 14.0%, P = 0.003; log-rank P = 0.010) than those with a high ESI. A low ESI was an independent risk factor for kidney dysfunction (adjusted HR = 1.36, 95% CI: 1.05–2.93, P = 0.043) and the development of hepatic encephalopathy (adjusted HR = 2.26; 95% CI: 2.05–3.13, P = 0.036). In addition, the presence of hepatic encephalopathy (the odds ratio (OR) = 2.26, 95% CI: 2.05–3.18, P = 0.006), spontaneous bacterial peritonitis (OR = 3.95, 95% CI: 1.01–5.46, P = 0.037), and kidney dysfunction (OR = 4.47, 95% CI: 1.02–9.64, P = 0.032) was independently associated with a low ESI in patients.ConclusionA low ESI is an independent risk factor for mortality in patients with HBV-ACLF, as well as the development of kidney dysfunction and hepatic encephalopathy.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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