A321 USING BEDSIDE ULTRASOUND AS A TOOL TO DETECT SARCOPENIA FOR CIRRHOTIC PATIENTS ON TRANSPLANT LIST
Notice bibliographique
Résumé
Muscle atrophy is present in as many as 40% of cirrhotic patients and associated with increased morbidity and mortality in those awaiting liver transplantation. A two-fold increase in mortality when compared to non-sarcopenic patients occurs independent of liver dysfunction evaluated using Model for End-Stage Liver Disease (MELD) score which does not incorporate markers of nutritional status, or muscle loss. Ultrasound offers the possibility of a non-invasive and affordable method to evaluate skeletal muscle at the bedside. It has been validated and is emerging as a valuable prognostic indicator of muscle atrophy, thereby improving detection of malnutrition at the individual level. We aim to evaluate quadriceps muscle layer thickness (QMLT) using ultrasound in cirrhotic patients waiting for liver transplantation across a range of nutritional risk scores based on Royal Free Hospital Nutrition Prioritizing Tool (RFNS). QMLT will also be compared to functional measures such as hand-grip and blood tests. A prospective study started in July 2016 using QMLT measures in a cohort of adult patients waiting for liver transplantation. Written informed consent is obtained on an individual bases. Measures of QMLT are obtained using the ultrasound probe at frequency 9 htz for each thigh at the middle and two-third point from superior iliac spine (SIS). Two residents who received expert training conduct measures. These measures will be compared to a nutrition score as well as synthetic markers of malnutrition, and functional measures of strength and endurance. Ten patients have been recruited so far. The average QMLT measured at two-thirds from SIS is 3 cm on both legs. The average thickness at the mid-point is 4.2 cm for both legs. Those patients considered at severe risk of malnutrition based on RFNS had either lower, or close to average QMLT when compared to the entire group. Two of the severely malnourished patients had a higher than average measurement which may reflect significant lower-leg edema. Serum vitamin A, and D levels were low in 6 patients and none of those had a higher than average QMLT. Average NaMELD score was 21 in 4 patients with low QMLT. Interestingly, the high RFNS patients had lower NaMELD scores. Hand grip measures on two patients were considered low for both of those who also had low QMLT. Results were consistent between both residents. Based on this prospective study, QMLT may offer and valuable and objective prognostic tool for detection of sarcopenia and high nutritional risk with consistent results. Significant lower leg edema may present a limitation of this tool. Future work is needed to optimize the ability of QMLT and to determine its importance in assessing the role of lean body mass in cirrhotic populations. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».