TY - JOUR
T1 - A comprehensive investigation of nutritional status and psoas muscle mass in predicting five-year survival in patients with liver transplant
AU - Tsao, Ya Tzu
AU - Lee, Wei Chen
AU - Huang, Chung Huei
AU - Lin, I. Hsin
AU - Huang, Yu Yao
N1 - Publisher Copyright:
© 2021 Formosan Medical Association
PY - 2022/7
Y1 - 2022/7
N2 - Background/Purpose: Although nutrition and sarcopenia have impacts on the surgery outcome of patients who have received living donor liver transplant (LDLT), the use of the prognostic nutritional index (PNI) or psoas muscle mass index (PMI) as an indicator for five-year survival in those patients is still unclear. Methods: A total of 138 patients receiving LDLT were followed at a medical center in Taiwan. As well as analysis of clinical factors using Cox regression, time-varying PNI and PMI values as before surgery (0) and at 3-, 6-, and 12- months after LDLT were analyzed by time-dependent Cox analysis. For those 124 patients who survived after 3 months of LDLT, the values of PNI-3m, PMI-3m and their combination were further analyzed. Results: PNI and PMI were noted to be highly associated with mortality at three months post-LDLT (PNI-3m hazard ratio [HR] = 0.89, 95% confidence interval [CI]: 0.85–0.94, p < 0.001; PMI-3m HR = 0.58, 95% CI: 0.41–0.82, p = 0.002). Per the Youden index, the cut-off point of PNI-3m was 42.35, and that of PMI-3m was 1.94. Compared to the subjects with higher levels of PNI-3m and PMI-3m (N-high/M-high), the HRs for subjects with N-high/M-low, N-low/M-high, and N-low/M-low were 5.27 (p = 0.004), 4.46 (p = 0.010) and 12.97 (p < 0.001) respectively. Conclusion: PNI and PMI at the third month post-LDLT serve as excellent predictors for 5-year survival. For patients with lower levels of PNI-3m or PMI-3m, combination use of these indexes is suggested to provide better prognostic information.
AB - Background/Purpose: Although nutrition and sarcopenia have impacts on the surgery outcome of patients who have received living donor liver transplant (LDLT), the use of the prognostic nutritional index (PNI) or psoas muscle mass index (PMI) as an indicator for five-year survival in those patients is still unclear. Methods: A total of 138 patients receiving LDLT were followed at a medical center in Taiwan. As well as analysis of clinical factors using Cox regression, time-varying PNI and PMI values as before surgery (0) and at 3-, 6-, and 12- months after LDLT were analyzed by time-dependent Cox analysis. For those 124 patients who survived after 3 months of LDLT, the values of PNI-3m, PMI-3m and their combination were further analyzed. Results: PNI and PMI were noted to be highly associated with mortality at three months post-LDLT (PNI-3m hazard ratio [HR] = 0.89, 95% confidence interval [CI]: 0.85–0.94, p < 0.001; PMI-3m HR = 0.58, 95% CI: 0.41–0.82, p = 0.002). Per the Youden index, the cut-off point of PNI-3m was 42.35, and that of PMI-3m was 1.94. Compared to the subjects with higher levels of PNI-3m and PMI-3m (N-high/M-high), the HRs for subjects with N-high/M-low, N-low/M-high, and N-low/M-low were 5.27 (p = 0.004), 4.46 (p = 0.010) and 12.97 (p < 0.001) respectively. Conclusion: PNI and PMI at the third month post-LDLT serve as excellent predictors for 5-year survival. For patients with lower levels of PNI-3m or PMI-3m, combination use of these indexes is suggested to provide better prognostic information.
KW - Liver transplant
KW - Prognostic nutritional index
KW - Psoas muscle mass index
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85117230913&partnerID=8YFLogxK
U2 - 10.1016/j.jfma.2021.09.020
DO - 10.1016/j.jfma.2021.09.020
M3 - 文章
C2 - 34666924
AN - SCOPUS:85117230913
SN - 0929-6646
VL - 121
SP - 1317
EP - 1324
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 7
ER -