A182 SIX-MINUTE WALK TEST AND SARCOPENIA IN PREDICTING MORTALITY IN PATIENTS WITH CIRRHOSIS
Bibliographic record
Abstract
Low muscle mass (sarcopenia) is associated with increased mortality in patients with cirrhosis. The association of functional performance with sarcopenia and its impact on mortality has not been well established in cirrhosis. 1) Determine the association of functional performance assessed by the six-minute walk test (6MWT) and sarcopenia 2) Assess the prognostic value of the 6MWT in patients with cirrhosis Patients who were assessed for liver transplant (LT) at the University of Alberta hospital were retrospectively enrolled in the study. Cross-sectional imaging within 1 year of assessment was used to determine sarcopenia. The third lumbar vertebra was used to quantify skeletal muscle cross sectional areas, which was then normalized to height to calculate the skeletal muscle index (SMI; cm2/m2). Sarcopenia was defined using pre-established cut-offs in patients with cirrhosis. Cut-offs for 6MWT to predict mortality (death or delisting for being too sick for LT) were determined using receiver-operating characteristic (ROC) curves. Cox proportional hazard models were conducted to assess associations between sarcopenia, functional performance assessed by the 6MWT, and mortality. There were a total of 180 cirrhotic patients who were evaluated for liver transplant who had a 6MWT test at the time of assessment and corresponding CT imaging (Table 1). There was a weak association between SMI and 6MWT observed as dimensional variables (r=0.022; P=0.003). A 6MWT < 489 m was independently associated with mortality, with AUC of 0.61 (95% CI, 0.51–0.71, P=0.03) and subsequently defined as “poor physical performance.” By univariate Cox analysis, both sarcopenia (HR 3.27; 95% CI 1.82–5.89; P<0.001) and low 6MWT (HR 2.72; 95% CI 1.45–5.13; P<0.001) were predictors of mortality. In a multivariate model, adjusted for MELD, sarcopenia (HR 2.96; 95% CI 1.59–5.51; P=0.001) and low 6MWT (HR 2.33; 95% CI 1.21–4.51; P=0.01) were independently associated with mortality. Poor physical performance was observed in 31 (60%) out of 52 sarcopenic patients. Sarcopenic patients with poor physical performance experienced a 6 times higher risk (HR 6.24; 95% CI 2.65–14.68; P<0.001) of death. Sarcopenic patients with low 6MWT survived for 25 months (95%CI, 12–38) compared to 69 months (95%CI, 27–112) in sarcopenic patients with normal 6MWT (Log Rank=0.04). Sarcopenia and poor physical performance independently associate with mortality in patients with cirrhosis. Although poor physical performance was observed in more than half of the sarcopenic patients, its ability to discriminate mortality requires further investigation. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".