Sarcopenia is associated with reduced 5-year survival in cirrhotic patients with age ≥ 65 and Child-Pugh score ≥ 7

Abstract Background Sarcopenia is prevalent worldwide and has a detrimental effect on the quality of life in cirrhosis patients. This study aimed to explore how the 5-year survival rate differs between young and older cirrhotic patients, as well as between patients with and without sarcopenia. Methods We retrospectively evaluated 320 cirrhotic patients. All patients were followed-up every 6 months for up to 5 years. Patients were divided into two groups (148 with sarcopenia and 172 without sarcopenia) according to the third lumbar skeletal muscle mass index [L3-SMI]. Furthermore, we compared difference in survival rates between young (< 65 years) and older patients, as well as between patients with and without sarcopenia. Results No significant difference was observed in clinical and biochemical parameters between young and old patients; however, significant difference was found in mid-arm muscle circumference, grip strength, and L3-SMI. Patients with sarcopenia were associated with worse 5-year survival rates than those without sarcopenia, regardless of their age group. Particularly, this effect was statistically significant in subgroups of Child-Pugh score ≥ 9. However, for patients aged 65 and over, the difference in 5-year survival rates between patients with and without sarcopenia was only statistically significant in subgroups of Child-Pugh score ≥ 7. Conclusions Sarcopenia is associated with poor prognosis of patients with cirrhosis. This effect is especially prominent in patients with age ≥ 65 and Child-Pugh score ≥ 7. Future studies focusing on nutritional intervention are warranted to confirm the effect of targeting sarcopenia on the long-term prognosis.