Sarcopenia is associated with longer hospital stay and multiorgan dysfunction in alcoholic hepatitis
Sarcopenia is associated with longer hospital stay and multiorgan dysfunction in alcoholic hepatitis
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DOI：
10.1097/meg.0000000000001583
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发表时间：
2020-06-01
影响因子：
2.1
通讯作者：
Szabo, Gyongyi
中科院分区：
文献类型：
--
作者：
Al-Azzawi, Yasir;Albo, Betty;Szabo, Gyongyi
在美国，过度饮酒已成为可预防死亡的第三大原因。最近大量研究表明，大量饮酒的后果之一是酒精性肝炎。虽然许多危险因素发展酒精性肝炎已被记录，我们在这项研究中的目的是探讨肌肉减少症和严重程度之间的潜在关联，死亡率，30天再入院率，并发症，感染和住院时间在酒精性hepatitis patients.Methods：一项回顾性分析，在一个大的，学术性医院在194酒精性肝炎患者年龄在18-60谁有横断面计算机断层扫描成像，并符合我们的临床定义酒精性肝炎。腰大肌指数的第五百分位数被用来作为一个截止为sarcopenias.Results：一百九十四例患者符合酒精性肝炎的标准，并进行了横断面成像。与非肌肉减少症组相比，在肌肉减少症组中发现了更高的终末期肝病模型评分（终末期肝病模型平均值分别为21.5和24.2，P = 0.03）。肌肉减少症也与住院时间显著延长相关;肌肉减少症组的平均住院时间为17.2天，而非肌肉减少症患者的平均住院时间为12.4天。我们发现更高的风险发展肺炎，败血症和肝性脑病的肌肉减少症patients.Conclusion：酒精性肝炎患者肌肉减少症有显着更糟糕的结果相比，没有肌肉减少症的患者，包括严重的酒精性肝炎，住院时间长，更高的风险发展肺炎，败血症和肝性脑病。
Introduction:Excessive alcohol consumption has steadily risen to become the third leading cause of preventable death in the USA. One consequence of heavy alcohol use recently under considerable investigation is alcoholic hepatitis. Although many risk factors for developing alcoholic hepatitis have been documented, our aim in this study was to examine the potential association between sarcopenia and severity, mortality, 30 days readmission rate, complication, infections and length of hospital stay in alcoholic hepatitis patients.Methods:A retrospective analysis was performed at a large, academic hospital in 194 alcoholic hepatitis patients aged 18-60 who had cross-sectional computed tomography imaging and met our clinical definition of alcoholic hepatitis. The fifth percentile of the psoas muscle index was used as a cutoff for sarcopenia.Results:One hundred ninety-four patients met the criteria for alcoholic hepatitis and had cross-sectional imaging. Higher Model for End-Stage Liver disease score was found in the sarcopenia group when compared to the non-sarcopenia group (mean Model for End-Stage Liver disease 21.5 and 24.2, respectively, P = 0.03). Sarcopenia also correlated with significantly longer hospital stay; the average length of stay in the sarcopenia group was 17.2 days while the non-sarcopenia patients had an average of 12.4 days. We found higher risk of developing pneumonia, sepsis and hepatic encephalopathy in sarcopenic patients.Conclusion:Alcoholic hepatitis patients with sarcopenia have significantly worse outcomes when compared with the patients without sarcopenia, including a severe form of alcoholic hepatitis, longer hospital stays, higher risk of developing pneumonia, sepsis and hepatic encephalopathy.