Impact of sarcopenia on variceal rebleeding in patients after endoscopic therapy: a multicenter retrospective cohort study based on propensity score matching

Abstract

Background

Sarcopenia is a common complication of liver cirrhosis and can be used for predicting dismal prognostic outcomes. This study aimed to evaluate the role of sarcopenia in rebleeding and mortality of liver cirrhosis patients after endoscopic therapy.

Methods

The liver cirrhosis patients who received endoscopic treatment were enrolled. Propensity score matching (PSM) was used to overcome selection bias. Two-year rebleeding episodes and mortality after endoscopic therapy were recorded.

Results

A total of 109 (32.4%) sarcopenia patients were reported. Before PSM, the frequency of rebleeding was significantly higher in the sarcopenia group relative to the non-sarcopenia group (41.3% vs. 15.9%, p < 0.001). Moreover, the multivariable analysis revealed that sarcopenia (p < 0.001, HR:2.596, 95% CI 1.591–4.237) was independently associated with a 2-year rebleeding episode. After PSM, the sarcopenia group exhibited an increased rebleeding rate as compared with non-sarcopenia group (44.4% vs. 15.3%, p < 0.001). According to multivariable analysis, sarcopenia (p < 0.001, HR:3.490, 95% CI 1.756–6.938) was identified as a significant predictor for 2-year rebleeding.

Conclusion

Sarcopenia was significantly associated with a high 2-year rebleeding rate in liver cirrhosis patients after endoscopic treatment. Therefore, the precise evaluation of a patient’s nutritional status, including sarcopenia becomes mandatory before endoscopic treatment.

Keywords:

• Liver cirrhosis
• endoscopic therapy
• rebleeding
• sarcopenia

Authors contributions

Yong Chen and Yanjing Gao equally contributed to the conception and design of the research; Yunqing Zeng and Jinhou Li contributed to the design of the research; Yongshuai Liu and Yuanyuan Liu contributed to the acquisition and analysis of the data; Jinhou Li and Huijun Chang contributed to the interpretation of the data; and Yongshuai Liu and Huijun Chang drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors will supply the relevant data in response to reasonable requests.

Additional information

Funding

This work was supported by the National Key Research and Development Program of China (Grant No. 2023YFC2507500) and the Grant from Shandong University (Grant No. 2021SDUCRCB005).