Body Composition Predicts Mortality and Decompensation in Compensated Cirrhosis Patients: A Prospective Cohort Study

Abstract Objective Body composition, particularly sarcopenia, is associated with mortality in patients with decompensated cirrhosis undergoing transplant evaluation. Similar data are limited for non-transplant eligible or compensated patients. Design 274 patients with cirrhosis were followed prospectively for 5 years after a CT scan. We utilized Analytic Morphomics to measure body composition (fat, muscle, and bone) which was rendered into relative values (percentiles) in relation to a reference population. Predictive models for survival were Model for Endstage Liver Disease (MELD) Score. We validated our models in a separate cohort. Results Our cohort had a mean Child score of 7.0 and a mean MELD of 11.3. The median follow-up time was 5.05 years. The proportion surviving at 1,3, and 5 years was 86.5%, 68.0%, and 54.3%; 13 (4.6%) underwent liver transplantation. Child B/C (versus A) cirrhosis was associated with decreased muscle, subcutaneous, and visceral fat area but increased subcutaneous/visceral fat density. Decreased normal density muscle mass was associated with mortality (HR 0.984, p Conclusion Body composition features enhance the prospective determination of prognosis for patients with cirrhosis, particularly those with compensated disease. Fat density, a novel feature, is associated with the risk of decompensation.