A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index
Abstract Background It is widely known that muscle mass influences the outcomes of many chronic diseases. Erector spine mass is a convenient parameter obtained from routine abdominal computed tomography (CT). The clinical application value of erector spine mass, and whether erector spine mass could...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-023-02995-x |
| _version_ | 1797559371104780288 |
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| author | Chao Zhou Yuan Liu Xiaoxiao Liang Ning Zhang Tingting He Jingjing Zhang Jin Zhang Shuangnan Fu Xin Li Pengcheng Liu Tianyi Zhang Man Gong |
| author_facet | Chao Zhou Yuan Liu Xiaoxiao Liang Ning Zhang Tingting He Jingjing Zhang Jin Zhang Shuangnan Fu Xin Li Pengcheng Liu Tianyi Zhang Man Gong |
| author_sort | Chao Zhou |
| collection | DOAJ |
| description | Abstract Background It is widely known that muscle mass influences the outcomes of many chronic diseases. Erector spine mass is a convenient parameter obtained from routine abdominal computed tomography (CT). The clinical application value of erector spine mass, and whether erector spine mass could predict the outcome of disease has not been studied. Aim To evaluate the role of the erector spine index (ESI) calculated based on abdominal CT imaging in the progression of acute-on-chronic liver failure related to the hepatitis B virus (HBV-ACLF). Methods We performed a retrospective study of 118 HBV-ACLF patients and calculated the ESI (the total erector spine area normalized for height2 in meters) for each patient through abdominal CT. The findings were analyzed regarding the progression of HBV-ACLF and the ESI at baseline, including mortality and the development of complications. Results The ESI level was associated with mortality and the development of complications. During the 90-day follow-up period, patients with a low ESI (<12.05 cm2/m2) had higher mortality than those with a high ESI (≥ 12.05 cm2/m2) (51.7% vs. 26.7%), and the cumulative survival rates were 71.0%±4.6 and 85.8%±3.9, respectively (log-rank P = 0.003). The hazard ratios (HRs) calculated using univariable and multivariable analyses were 2.23(95% confidence interval (CI): 1.25–4.21, P = 0.005) and 2.52 (95% CI: 1.34–9.24, P = 0.011), respectively. Patients with a low ESI (<12.05 cm2/m2) had higher incidences of kidney dysfunction (43.5% vs. 23.2%, P = 0.029; log-rank P = 0.017) and hepatic encephalopathy (39.6% vs. 14.0%, P = 0.003; log-rank P = 0.010) than those with a high ESI. A low ESI was an independent risk factor for kidney dysfunction (adjusted HR = 1.36, 95% CI: 1.05–2.93, P = 0.043) and the development of hepatic encephalopathy (adjusted HR = 2.26; 95% CI: 2.05–3.13, P = 0.036). In addition, the presence of hepatic encephalopathy (the odds ratio (OR) = 2.26, 95% CI: 2.05–3.18, P = 0.006), spontaneous bacterial peritonitis (OR = 3.95, 95% CI: 1.01–5.46, P = 0.037), and kidney dysfunction (OR = 4.47, 95% CI: 1.02–9.64, P = 0.032) was independently associated with a low ESI in patients. Conclusion A low ESI is an independent risk factor for mortality in patients with HBV-ACLF, as well as the development of kidney dysfunction and hepatic encephalopathy. |
| first_indexed | 2024-03-10T17:44:25Z |
| format | Article |
| id | doaj.art-f335cf6a4c3142d29b4627ad96b43e18 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-03-10T17:44:25Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-f335cf6a4c3142d29b4627ad96b43e182023-11-20T09:35:58ZengBMCBMC Gastroenterology1471-230X2023-10-012311910.1186/s12876-023-02995-xA novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine indexChao Zhou0Yuan Liu1Xiaoxiao Liang2Ning Zhang3Tingting He4Jingjing Zhang5Jin Zhang6Shuangnan Fu7Xin Li8Pengcheng Liu9Tianyi Zhang10Man Gong11Department of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Diagnostic Radiology, 5th Medical Center of Chinese PLA General HospitalBeijing Chaoyang Integrative Medicine Emergency CenterDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalDepartment of Liver Disease, 5th Medical Center of Chinese PLA General HospitalAbstract Background It is widely known that muscle mass influences the outcomes of many chronic diseases. Erector spine mass is a convenient parameter obtained from routine abdominal computed tomography (CT). The clinical application value of erector spine mass, and whether erector spine mass could predict the outcome of disease has not been studied. Aim To evaluate the role of the erector spine index (ESI) calculated based on abdominal CT imaging in the progression of acute-on-chronic liver failure related to the hepatitis B virus (HBV-ACLF). Methods We performed a retrospective study of 118 HBV-ACLF patients and calculated the ESI (the total erector spine area normalized for height2 in meters) for each patient through abdominal CT. The findings were analyzed regarding the progression of HBV-ACLF and the ESI at baseline, including mortality and the development of complications. Results The ESI level was associated with mortality and the development of complications. During the 90-day follow-up period, patients with a low ESI (<12.05 cm2/m2) had higher mortality than those with a high ESI (≥ 12.05 cm2/m2) (51.7% vs. 26.7%), and the cumulative survival rates were 71.0%±4.6 and 85.8%±3.9, respectively (log-rank P = 0.003). The hazard ratios (HRs) calculated using univariable and multivariable analyses were 2.23(95% confidence interval (CI): 1.25–4.21, P = 0.005) and 2.52 (95% CI: 1.34–9.24, P = 0.011), respectively. Patients with a low ESI (<12.05 cm2/m2) had higher incidences of kidney dysfunction (43.5% vs. 23.2%, P = 0.029; log-rank P = 0.017) and hepatic encephalopathy (39.6% vs. 14.0%, P = 0.003; log-rank P = 0.010) than those with a high ESI. A low ESI was an independent risk factor for kidney dysfunction (adjusted HR = 1.36, 95% CI: 1.05–2.93, P = 0.043) and the development of hepatic encephalopathy (adjusted HR = 2.26; 95% CI: 2.05–3.13, P = 0.036). In addition, the presence of hepatic encephalopathy (the odds ratio (OR) = 2.26, 95% CI: 2.05–3.18, P = 0.006), spontaneous bacterial peritonitis (OR = 3.95, 95% CI: 1.01–5.46, P = 0.037), and kidney dysfunction (OR = 4.47, 95% CI: 1.02–9.64, P = 0.032) was independently associated with a low ESI in patients. Conclusion A low ESI is an independent risk factor for mortality in patients with HBV-ACLF, as well as the development of kidney dysfunction and hepatic encephalopathy.https://doi.org/10.1186/s12876-023-02995-xErector spine massPrognosisLiver FailureHepatic encephalopathyKidney dysfunction |
| spellingShingle | Chao Zhou Yuan Liu Xiaoxiao Liang Ning Zhang Tingting He Jingjing Zhang Jin Zhang Shuangnan Fu Xin Li Pengcheng Liu Tianyi Zhang Man Gong A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index BMC Gastroenterology Erector spine mass Prognosis Liver Failure Hepatic encephalopathy Kidney dysfunction |
| title | A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index |
| title_full | A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index |
| title_fullStr | A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index |
| title_full_unstemmed | A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index |
| title_short | A novel imaging index for predicting adverse progression in acute-on-chronic liver failure related to hepatitis B virus: the low erector spine index |
| title_sort | novel imaging index for predicting adverse progression in acute on chronic liver failure related to hepatitis b virus the low erector spine index |
| topic | Erector spine mass Prognosis Liver Failure Hepatic encephalopathy Kidney dysfunction |
| url | https://doi.org/10.1186/s12876-023-02995-x |
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