Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis
Abstract Background and Aim Polypharmacy and sarcopenia are increasing public health problems worldwide. However, data on the prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis are limited. Methods Polypharmacy and sarcopenia were ass...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.12877 |
| _version_ | 1797860933914066944 |
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| author | Tatsunori Hanai Kayoko Nishimura Takao Miwa Toshihide Maeda Kenji Imai Atsushi Suetsugu Koji Takai Masahito Shimizu |
| author_facet | Tatsunori Hanai Kayoko Nishimura Takao Miwa Toshihide Maeda Kenji Imai Atsushi Suetsugu Koji Takai Masahito Shimizu |
| author_sort | Tatsunori Hanai |
| collection | DOAJ |
| description | Abstract Background and Aim Polypharmacy and sarcopenia are increasing public health problems worldwide. However, data on the prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis are limited. Methods Polypharmacy and sarcopenia were assessed in 239 patients with liver cirrhosis. Polypharmacy was defined as the daily use of six or more medications, and sarcopenia was diagnosed based on muscle strength and mass evaluated on computed tomography. The association between polypharmacy and sarcopenia and their effects on mortality were analyzed using logistic regression and Cox proportional hazards models. Results Among the 239 patients, 52% were men, the median age was 68 years, and the number of medications used per patient was 6. Further, 53% and 29% patients had polypharmacy and sarcopenia, respectively. The number of medications used and the prevalence of sarcopenia increased with age. Patients with polypharmacy and sarcopenia had similar characteristics, such as older age, increased medication use, advanced liver disease, and decreased muscle strength and mass. After adjusting for confounders, polypharmacy was significantly associated with sarcopenia (odds ratio, 2.11; 95% confidence interval [CI], 1.07–4.17). During the median follow‐up of 2.2 years, 62 (26%) patients died. Polypharmacy (hazard ratio [HR], 1.83; 95% CI, 1.01–3.37) and sarcopenia (HR, 2.00; 95% CI, 1.12–3.50) independently predicted mortality. The prognostic significance of polypharmacy was more prominent in older adults than in younger adults (HR, 2.31; 95% CI, 1.01–5.67). Conclusion Polypharmacy and sarcopenia are interrelated and associated with poor prognosis in patients with cirrhosis. Further large, prospective, population‐based studies are required to validate these findings. |
| first_indexed | 2024-04-09T21:53:53Z |
| format | Article |
| id | doaj.art-2488aca882c94797a5fb426333d49c38 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-04-09T21:53:53Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-2488aca882c94797a5fb426333d49c382023-03-24T06:55:37ZengWileyJGH Open2397-90702023-03-017320821410.1002/jgh3.12877Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosisTatsunori Hanai0Kayoko Nishimura1Takao Miwa2Toshihide Maeda3Kenji Imai4Atsushi Suetsugu5Koji Takai6Masahito Shimizu7Department of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanCenter for Nutrition Support and Infection Control Gifu University Hospital Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanDepartment of Gastroenterology/Internal Medicine Gifu University Graduate School of Medicine Gifu JapanAbstract Background and Aim Polypharmacy and sarcopenia are increasing public health problems worldwide. However, data on the prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis are limited. Methods Polypharmacy and sarcopenia were assessed in 239 patients with liver cirrhosis. Polypharmacy was defined as the daily use of six or more medications, and sarcopenia was diagnosed based on muscle strength and mass evaluated on computed tomography. The association between polypharmacy and sarcopenia and their effects on mortality were analyzed using logistic regression and Cox proportional hazards models. Results Among the 239 patients, 52% were men, the median age was 68 years, and the number of medications used per patient was 6. Further, 53% and 29% patients had polypharmacy and sarcopenia, respectively. The number of medications used and the prevalence of sarcopenia increased with age. Patients with polypharmacy and sarcopenia had similar characteristics, such as older age, increased medication use, advanced liver disease, and decreased muscle strength and mass. After adjusting for confounders, polypharmacy was significantly associated with sarcopenia (odds ratio, 2.11; 95% confidence interval [CI], 1.07–4.17). During the median follow‐up of 2.2 years, 62 (26%) patients died. Polypharmacy (hazard ratio [HR], 1.83; 95% CI, 1.01–3.37) and sarcopenia (HR, 2.00; 95% CI, 1.12–3.50) independently predicted mortality. The prognostic significance of polypharmacy was more prominent in older adults than in younger adults (HR, 2.31; 95% CI, 1.01–5.67). Conclusion Polypharmacy and sarcopenia are interrelated and associated with poor prognosis in patients with cirrhosis. Further large, prospective, population‐based studies are required to validate these findings.https://doi.org/10.1002/jgh3.12877cirrhosismultimorbidityolder adultspolypharmacysarcopenia |
| spellingShingle | Tatsunori Hanai Kayoko Nishimura Takao Miwa Toshihide Maeda Kenji Imai Atsushi Suetsugu Koji Takai Masahito Shimizu Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis JGH Open cirrhosis multimorbidity older adults polypharmacy sarcopenia |
| title | Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis |
| title_full | Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis |
| title_fullStr | Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis |
| title_full_unstemmed | Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis |
| title_short | Prevalence, association, and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis |
| title_sort | prevalence association and prognostic significance of polypharmacy and sarcopenia in patients with liver cirrhosis |
| topic | cirrhosis multimorbidity older adults polypharmacy sarcopenia |
| url | https://doi.org/10.1002/jgh3.12877 |
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