15 Few studies have considered the association between the psoas muscle cross-sectional area and physical performance in ambulatory patients with liver cirrhosis aged < 65 years. Previous studies have demonstrated that the psoas muscle cross-sectional area differs according to age and sex however, in this study, no differences in the psoas muscle cross-sectional area were found according to age and sex when the area was normalized by the patient’s height. In the current study, the psoas muscle cross-sectional area was identified as a useful factor that was not associated with the severity of liver cirrhosis and was associated with physical performance. 5, 14 Therefore, various evaluations and predictions using the psoas muscle have been attempted in patients with liver cirrhosis. reported that the psoas muscle thickness divided by the patient’s height is a useful factor for predicting long-term mortality in patients with liver cirrhosis with ascites. previously suggested the clinical usefulness of the psoas muscle thickness for diagnosing sarcopenia in patients with liver cirrhosis, and Kim et al. The psoas muscle cross-sectional area, grip strength, and serum albumin were identified as factors affecting SPPB ( Table 4). In multiple regression analysis, all independent variables were entered into the equation. The psoas muscle cross-sectional area, grip strength, and serum albumin showed significance in univariate analysis. The mean value of serum albumin was statistically significant according to the severity of liver cirrhosis however, the differences in the mean values of the psoas muscle cross-sectional area, SMI, and SPPB according to liver cirrhosis severity were not statistically significant in the Kruskal-Wallis test ( Table 3). In the Mann Whitney U-test, SPPB had a significant difference according to serum albumin ( P = 0.003) but showed no significant difference according to sex ( Table 2). SPPB had no significant correlation with SMI, age, or body mass index ( Table 2). In bivariate correlation analysis, the psoas muscle cross-sectional area was significantly correlated with SPPB (r = 0.459, P < 0.01). The inter-rater correlation coefficient was 0.959, with a P-value of 0.000. The number of patients with Child-Pugh class A, B, and C was 25, 8, and 13, respectively ( Table 1). This study was approved by the Institutional Review Board of OO university hospital.Ī total of 46 patients (36 men, 10 women) were finally included in this study (the sample size calculated by MedCalc was 50 patients). 10 The sample size was obtained using the correlation coefficient between the psoas muscle cross-sectional area and SPPB calculated with MedCalc (MedCalc Software, Ostend, Belgium), with a power of 0.80 and a significance of 0.01. The severity of liver cirrhosis was determined according to the Child-Pugh classification. The exclusion criteria were as follows: (1) advanced liver cancer at the time of liver cirrhosis diagnosis (2) a history of neurologic disease that may affect physical performance (3) active encephalopathy due to liver cirrhosis and (4) inability to maintain a neutral anteroposterior position because of a spinal disease, such as scoliosis. The inclusion criteria were as follows: (1) an initial diagnosis of liver cirrhosis based on abdominal CT and liver biopsy results (2) ability to ambulate and (3) age < 65 years, to rule out low physical performance due to aging. This study involved a retrospective review of medical charts of patients diagnosed with liver cirrhosis at OO university hospital between December 2018 and December 2019.
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