Journal of Clinical Hepatology
This article mainly studies the predictive value of the third lumbar skeletal muscle mass index (L3-SMI) for the long-term prognosis of patients with acute-on-chronic liver failure (ACLF). The study retrospectively analyzed the clinical data of 126 ACLF patients, combined with abdominal CT to measure L3-SMI, and compared it with MELD and Child-Pugh scores. The results showed that the L3-SMI in the death group was significantly lower than that in the survival group, indicating a close relationship between sarcopenia and poor prognosis. The AUC value of L3-SMI combined with MELD and Child-Pugh scores in predicting 2-year mortality was better than that of using only the latter two, showing stronger predictive power. The innovation lies in the first systematic evaluation of the independent predictive effect of L3-SMI on the long-term prognosis of ACLF patients, and proposes that integrating muscle mass indicators into existing liver function score models can improve predictive accuracy. This study emphasizes the importance of nutritional status, especially skeletal muscle content, in the evaluation of ACLF, and provides new ideas for optimizing the prognosis scoring system.
The main significance of this study lies in exploring the value of L3-SMI (third lumbar skeletal muscle mass index) combined with MELD and Child-Pugh scores in predicting the prognosis of patients with acute-on-chronic liver failure (ACLF). ACLF is a severe condition, and prognosis assessment is crucial for clinical decision-making. Traditional scoring systems such as MELD and Child-Pugh are widely used, but there are limitations in predictive accuracy. This study found that the combined model significantly improved predictive power by quantitatively analyzing the skeletal muscle content (L3-SMI) of patients with CT imaging, combining liver function and clinical indicators. ROC curve analysis showed that the combined L3-SMI, MELD, and Child-Pugh scores had a higher AUC value, indicating better diagnostic power than single or combined indicators. In addition, the study corrected the impact of fluid retention on body weight, improving the accuracy of BMI and L3-SMI assessment. The results show that sarcopenia is an important factor affecting the prognosis of ACLF patients, and multimodal indicator integration can optimize risk stratification. This method provides a more accurate prognosis assessment tool for clinical use, helping with early intervention and individualized treatment. Ethical approval and multicenter data support also enhance the scientificity and reliability of the study.
Objective: To investigate the value of third lumbar skeletal muscle mass index (L3-SMI) in predicting the long-term prognosis of pati…
