Value of the controlling nutritional status score and psoas muscle thickness per height in predicting prognosis in liver transplantation

doi:10.12998/wjcc.v9.i35.10871

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World Journal of Clinical Cases

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World J Clin Cases. Dec 16, 2021; 9(35): 10871-10883
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10871

Table 1 Relationship between the controlling nutritional status score and general patient clinical data

Group	Low CONUT	Medium CONUT	High CONUT	P value
Age	49.7 ± 9.9	50.2 ± 9.8	46.6 ± 10.1	0.102
Sex (M:F)	48:17	128:45	34:9	0.801
BMI (kg/m²)	23.5 (21.2-25.4)	23.7 (21.6-27.0)	24.3 (21.8-28.0)	0.515
MELD score	14 (10-20)	15 (10-21)	18 (13-21)	0.155
Etiology				0.386
HBV (n)	42	90	22
HCV (n)	1	2	0
Alcohol (n)	4	20	5
NASHE(n)	4	10	2
Autoimmune diseases (n)	8	23	11
Cryptogenic (n)	1	2	1
Other (n)	4	26	3

BMI: Body mass index; CONUT: Controlling nutritional status; F: Female; HBV: Hepatitis B virus; HCV: Hepatitis C virus; M: Male; MELD: Model for end-stage liver disease; NASH: Nonalcoholic steatohepatitis.

Table 2 Relationship between the controlling nutritional status score and general patient laboratory data

Group	Low CONUT	Medium CONUT	High CONUT	P value
HB (g/L)	122.6 ± 25.5	96.8 ± 26.52	89.2 ± 17.9	< 0.001^a; < 0.001^b; 0.074^c
WBC (cells/mm³)	4.95 (3.24-6.54)	4.63 (3.43-6.94)	4.8 ± 3.3	0.101
PLT (cells/mm³)	113.0 (58.0-116.5)	105.0 (46.5-166.0)	111.1 ± 79.1	0.493
Albumen (g/L)	38.8 ± 4.53	31.8 (29.0-34.4)	26.34 ± 2.65	< 0.001^a; < 0.001^b; < 0.001^c
Total cholesterol (mg/dL)	148.08 (117.75-178.81)	102.67 (81.39-113.68)	80.7 ± 29.81	< 0.001^a; < 0.001^b; < 0.001^c
Total lymphocytes (cells/mm³)	1190 (860-1730)	700 (440-1170)	530(380-770)	< 0.001^a; < 0.001^b; < 0.001^c
Intraoperative data
Packed red cell transfusion (units)	6.0 (4.0-10.0)	10.0 (8.0-12.0)	10.0 (8.0-16.0)	< 0.001^a; < 0.001^b; 0.158^c
Frozen plasma transfusion (mL)	1800.0 (1000.0-2100.0)	2000.0 (1600.0-2000.0)	2078.6 ± 638.4	0.180^a; 0.018^b; 0.319^c
Blood loss (mL)	1600.0 (800.0-2000.0)	2000.0 (1500.0-2400.0)	2000.0 (1500.0-2400.0)	0.069^a; 0.004^b; 1.00^c
Anhepatic phase (min)	42.0 (40.0-50.0)	45.0 (37.0-50.0)	45.0 ± 11.4	0.849
Operation time (h)	7.5 (6.7-8.3)	7.5 (7.0-8.4)	7.5 (6.6-9.0)	0.542
Postoperative data
Time of ventilator extubation (h)	6.0 (4.0-9.0)	10.5 (5.0-31.4)	6.5 (3.5-24.0)	0.237
ICU stay (d)	3.0 (2.0-4.0)	4.0 (3.0-4.9)	3.0 (3.0-4.96)	< 0.001^a; 0.049^b; 1.00^c
hospital stay (d)	25.0 (21.0-30.0)	35.0 (26.0-37.3)	33.0 (27.0-38.0)	< 0.001^a; < 0.001^b; 0.94^c
Day 7 TBil (μmol/L)	30.0 (18.09-43.5)	48.0 (27.5-75.5)	55.6± 37.9	0.21^a; 0.01^b; 1.00^c
Day 14 TBil (µmol/L)	19.0 (13.25-32.0)	33.0 (19.0-51.9)	42.0 (22.0-72.0)	0.01^a; < 0.001^b; 1.00^c
Day 7 AST (U/L)	27.0 (19.5-35.8)	24.0 (15.5-39.1)	26.3 ± 16.5	0.180
Day 14 AST (U/L)	25.0 (20.1-38.0)	26.0 (18-0-39.5)	26.0 (17.0-40.0)	0.809
Day 7 ALT (U/L)	79.0 (56.5-104.0)	65.0 (39.0-97.5)	57.0 (34.0-93.0)	0.685^a; 0.019^b; 0.069^c
Day 14 ALT (U/L)	61.0 (35.0-81.5)	47.0 (32.5-72.3)	43.0 (21.0-70.0)	0.153
Day 7 INR	1.31 (1.14-1.47)	1.30 (1.15-1.51)	1.27 (1.15-1.34)	0.719
Day 14 INR	1.26 (1.08-1.27)	1.34 (1.15-1.51)	1.34 (1.13-1.71)	0.499
Day 7 Cr (μmol/L)	55.0 (46.2-63.0)	62.0 (49.0-80.5)	57.0 (40.0-71.0)	0.097
Day 14 Cr (μmol/L)	58.0 (45.5-68.0)	62.0 (49.0-73.5)	59.1 ± 23.4	0.161
Day 7 BUN (mmol/L)	7.71 (5.04-9.45)	8.2 (6.1-11.5)	7.5 (5.8-10.7)	0.71
Day 14 BUN (mmol/L)	5.28(4.30-6.75)	7.13 (5.20-9.52)	6.0 (4.6-8.9)	0.13^a; 0.01^b; 0.796^c

^aLow controlling nutritional status (CONUT) and medium CONUT group.

^bLow CONUT and high CONUT group.

^cMedium CONUT group and high CONUT group. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BUN: Blood urea nitrogen; CONUT: Controlling nutritional status; Cr: Creatinine; HB: Hemoglobin; ICU: Intensive care unit; INR: International normalized ratio; PLT: Platelet; TBil: Total bilirubin; WBC: White blood cell.

Table 3 Relationship between controlling nutritional status score and postoperative complications

Group	Low CONUT	Medium CONUT	High CONUT	P value
Cases	65	173	43
Grade III complications	8 (12.3)	61 (35.3)	19 (44.2)	< 0.01^a; 0.01^b; 0.278^c
Grade IV complications	1 (1.5)	16 (9.2)	5 (11.6)	0.04^a; 0.025^b; 0.054^c
Grade V complications	1 (1.5)	17 (9.8)	3 (7.0)	0.031^a; 0.143^b; 0.564^c
Graft loss	1 (1.5)	4(2.3)	1 (2.3)	1.000
Infections	17 (26.1)	82 (47.4)	25 (58.1)	0.03^a; 0.01^b; 0.207^c

^aLow controlling nutritional status (CONUT) and medium CONUT group.

^bLow CONUT and high CONUT group.

^cMedium CONUT group and high CONUT group. CONUT: Controlling nutritional status.

Table 4 Relationship between psoas muscle thickness/height and general patient clinical data

Group	Low PMTH	High PMTH	P value
Cases	81	173
Age (yr)	50.6 ± 9.8	50.7 ± 8.8	0.765
Sex (M:F)	63:18	127:46	0.455
BMI (kg/m²)	23.0 (20.9-26.0)	24.1 (21.8-26.4)	0.069
MELD score	16 (11-21.5)	14 (10-20)	0.237
Etiology			0.712
HBV (n)	41	99
HCV (n)	2	3
Alcohol (n)	11	14
NASH (n)	5	10
Autoimmune disease (n)	10	18
Cryptogenic (n)	0	3
Other (n)	12	26

BMI: Body mass index; F: Female; HBV: Hepatitis B virus; HCV: Hepatitis C virus; M: Male; MELD: Model for end-stage liver disease; NASH: Nonalcoholic steatohepatitis. PMTH: Psoas muscle thickness per height.

Table 5 Relationship between psoas muscle thickness per height and general patient laboratory data

Group	Low PMTH	High PMTH	P value
BUN (mmol/L)	5.98 (4.06-10.22)	4.64 (3.52-6.03)	0.001
HB (g/L)	97.22 ± 21.84	102.77 ± 23.35	0.085
WBC (cells/mm³)	5.14 (3.71-8.26)	4.73 (3.14-6.22)	0.066
PLT (cells/mm³)	120.0 (55.5-171.5)	112.0 (51.0-161.0)	0.505
Album (g/L)	33.6 ± 6.1	37.1 ± 5.6	0.067
Total cholesterol (mg/dL)	1050.2 ± 520.4	1010.1 ± 550.9	0.624
Total lymphocytes (cells/mm³)	820 (510-1320)	720 (490-1000)	0.124
Intraoperativedata
Packed red cell transfusion (units)	10.0 (8.0-12.0)	8.0 (6.0-10.0)	0.003
Frozen fresh;plasm transfusion (mL)	2000.0 (1800.0-2350.0)	1800.0 (1400.0-2000.0)	0.001
Blood loss (mL)	2000 (1500-2350.0)	1900.0 (1500.0-2000.0)	0.180
Anhepatic phase (min)	45 (35.5-50)	45.0 (40.0-50.0)	0.932
Operation time (h)	7.75 (7.0-8.6)	7.5 (7.0-8.5)	0.649
Postoperative data
Time of ventilatorextubation (h)	7.0 (4.0-32.5)	6.0 (4.0-12.5)	0.043
ICU stay (d)	4.0 (2.5-4.7)	3.0 (2.0-4.0)	0.113
Hospital stay (d)	29.0 (23.0-31.5)	28.0 (23.0-35.7)	0.968
Day 7 TBil (μmol/L)	41.0 (20.0-63.7)	37.0 (24.3-62.0)	0.774
Day 14 TBil (μmol/L)	29.0 (16.0-43.9)	27.1 (16.9-44.5)	0.998
Day 7 AST (U/L)	18.0 (13.5-32.5)	25.0 (17.1-38.0)	0.005
Day 14 AST(U/L)	24.0 (16.0-27.0)	28.0 (19.0-42.5)	0.008
Day 7 ALT (U/L)	55.0 (32.5-83.5)	74.0 (48.5-102.5)	0.002
Day 14 ALT (U/L)	41.0 (26.0-48.5)	57.0 (34.0-88.6)	0.001
Day 7 INR	1.28 (1.15-1.49)	1.24 (1.13-1.43)	0.291
Day 14 INR	1.29 (1.13-1.29)	1.31 (1.12-1.51)	0.891
Day 7 Cr (μmol/L)	57.0 (50.3-67.8)	60.0 (50.5-73.0)	0.196
Day 14 Cr (μmol/L)	61.0 (48.5-69.0)	60.0 (48.0-75.0)	0.982
Day 7 BUN (mmol/L)	8.47 (5.95-11.4)	7.83 (6.05-10.41)	0.264
Day 14 BUN (mmol/L)	7.2 (4.9-9.0)	6.04 (4.75-8.15)	0.203

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BUN: Blood urea nitrogen. Cr: Creatinine; HB: Hemoglobin; ICU: Intensive care unit; INR: International normalized ratio; PLT: Platelet; PMTH: Psoas muscle thickness per height; TBil: Total bilirubin; WBC: White blood cell.

Table 6 Relationship between psoas muscle thickness/height and postoperative complications

Group	Low PMTH	High PMTH	P value
Cases	81	173
Grade III complications	25 (30.9)	43 (24.9)	0.313
Grade IV complications	8 (9.9)	12 (6.9)	0.630
Grade V complications	14 (17.3)	5 (2.9)	< 0.001
Total complications	47 (58.0)	60 (34.7)	0.001
Graft loss	2 (2.5)	3 (1.7)	1.000
Infection	36 (44.4)	65 (37.6)	0.297

PMTH: Psoas muscle thickness per height.

Citation: Dai X, Gao B, Zhang XX, Li J, Jiang WT. Value of the controlling nutritional status score and psoas muscle thickness per height in predicting prognosis in liver transplantation. World J Clin Cases 2021; 9(35): 10871-10883
URL: https://www.wjgnet.com/2307-8960/full/v9/i35/10871.htm
DOI: https://dx.doi.org/10.12998/wjcc.v9.i35.10871