The aim of this study is to validate a proposed definition of sarcopenia in predicting wait‐list mortality. We retrospectively evaluated 355 adults (age ≥18 years) with cirrhosis listed for first‐time LT from January 1, 2010, to April 1, 2018 from our center. Demographic, laboratory, and outcome data were collected in conjunction with computed tomography scans performed within 3 months of listing. Using imaging analysis software, the skeletal muscle index (SMI), which is a marker for sarcopenia‐related mortality, was calculated. A survival analysis was performed to evaluate the association of the proposed sarcopenia definition of SMI <50 cm²/m² for men or <39 cm²/m² for women with wait‐list mortality or delisting. Median SMI was 54.1 cm²/m² (range, 47‐60 cm²/m²). A total of 61 (17.2%) patients exhibited sarcopenia according to the proposed threshold, and 24.6% (57/232) of men were sarcopenic compared with 3.3% (4/123) of women (P < 0.001). Mean (standard deviation [SD]) SMI was also higher for men (56.6 ± 9.6 cm²/m²) than for women (50.7 ± 8.0 cm²/m²; P < 0.001). Median follow‐up time among patients was 2.1 months (0‐12 months), and 30 events were observed (hazard ratio, 0.98; 95% confidence interval, 0.95‐1.02; P = 0.41). There was no statistically significant difference in time on the waiting list between patients with and without sarcopenia (P = 0.89) as defined at the threshold. Using the prespecified definitions of sarcopenia based on SMI, there was no statistically significant difference in mortality and delisting from the transplant waiting list between patients with and without sarcopenia in this population. Practice and region‐specific patterns for pretransplant selection and median Model for End‐Stage Liver Disease at transplant may affect SMI as a predictor of wait‐list mortality.

中文翻译：

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终末期肝病患者使用骨骼肌指数作为等待名单死亡率的预测指标。

这项研究的目的是验证在预测候诊者死亡率时少肌症的定义。我们回顾性评估了我们中心从2010年1月1日至2018年4月1日首次入选LT的355例肝硬化成年人（≥18岁）。人口统计，实验室数据和结果数据是在上市后3个月内与计算机断层扫描相结合收集的。使用成像分析软件计算骨骼肌指数（SMI），这是与肌肉减少症相关的死亡率的指标。进行了生存分析，以评估男性的SMI <50 cm ² / m ²或<39 cm ² / m ²的提议的肌肉减少症定义的关联适用于等待名单上死亡或退市的女性。SMI中位数为54.1 cm ² / m ²（范围47-60 cm ² / m ²）。按照建议的阈值，共有61位患者（17.2％）表现出肌肉减少症，男性的24.6％（57/232）患有肌肉减少症，而女性的这一比例为3.3％（4/123）（P  <0.001）。男性（56.6±9.6 cm ² / m ²）的平均（标准差[SD]）也高于女性（50.7±8.0 cm ² / m ²；P  <0.001）。患者的中位随访时间为2.1个月（0-12个月），观察到30例事件（危险比，0.98； 95％置信区间，0.95-1.02；P = 0.41）。有和没有肌肉减少症的患者之间的轮候时间差异无统计学意义（P  = 0.89），如阈值所定义。使用基于SMI的肌肉减少症的预先定义，在该人群中有和没有肌肉减少症的患者之间的死亡率和从移植等待名单中除名的统计学差异均无统计学意义。移植前选择的实践和地区模式以及移植时终末期肝病中位模型可能会影响SMI作为等待清单死亡率的预测指标。