Background: Minimal hepatic encephalopathy (MHE) is considered a risk factor for falls in patients with liver cirrhosis. However, MHE is prevalent in patients with muscle alterations (sarcopenia and myosteatosis) probably due to the role of muscle in ammonia handling. Aim: To assess the respective role of muscle alterations and MHE on the risk of falls in cirrhotic patients. Methods: Fifty cirrhotics were studied for MHE detection by using Psychometric Hepatic Encephalopathy Score (PHES) and Animal Naming Test (ANT). CT scan was used to quantify the skeletal muscle index (SMI) and muscle attenuation, as a measure of myosteatosis. The risk of falls was evaluated by the Timed Up&Go test (TUG). The occurrence of falls during follow up was also detected. RESULTS: 32 patients (64%) had an abnormal TUG (< 14 s). In the group with TUG ≥ 14 s, MHE (72vs31%, p<0.005) and myosteatosis (94vs50%, p = 0.002) were significantly more frequent than in patients with TUG<14 s. At multivariate the variables independently associated to TUG ≥ 14 s were myosteatosis, MHE and chronic beta-blockers use. During a mean follow-up of 25±16.9 months, 12 patients fell; the percentage of falls was significantly higher in patients with TUG ≥ 14 s (50%vs9%, p = 0.001) as well as in patients with myosteatosis (33%vs6%, p = 0.03), but similar in patients with or without MHE (35%vs15%, NS). Conclusion: In cirrhotic patients both muscle alterations and cognitive impairment, as well as chronic beta-blockers use, are associated to the risk of falls.

Risk of falls in patients with cirrhosis evaluated by timed up and go test. Does muscle or brain matter more? / Nardelli, S.; Gioia, S.; Ridola, L.; Carlin, M.; Cioffi, A. D.; Merli, M.; Riggio, O.; Spagnoli, A.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - (2022), pp. 1-7. [10.1016/j.dld.2021.06.019]

Risk of falls in patients with cirrhosis evaluated by timed up and go test. Does muscle or brain matter more?

Nardelli S.;Ridola L.;Merli M.;Spagnoli A.
2022

Abstract

Background: Minimal hepatic encephalopathy (MHE) is considered a risk factor for falls in patients with liver cirrhosis. However, MHE is prevalent in patients with muscle alterations (sarcopenia and myosteatosis) probably due to the role of muscle in ammonia handling. Aim: To assess the respective role of muscle alterations and MHE on the risk of falls in cirrhotic patients. Methods: Fifty cirrhotics were studied for MHE detection by using Psychometric Hepatic Encephalopathy Score (PHES) and Animal Naming Test (ANT). CT scan was used to quantify the skeletal muscle index (SMI) and muscle attenuation, as a measure of myosteatosis. The risk of falls was evaluated by the Timed Up&Go test (TUG). The occurrence of falls during follow up was also detected. RESULTS: 32 patients (64%) had an abnormal TUG (< 14 s). In the group with TUG ≥ 14 s, MHE (72vs31%, p<0.005) and myosteatosis (94vs50%, p = 0.002) were significantly more frequent than in patients with TUG<14 s. At multivariate the variables independently associated to TUG ≥ 14 s were myosteatosis, MHE and chronic beta-blockers use. During a mean follow-up of 25±16.9 months, 12 patients fell; the percentage of falls was significantly higher in patients with TUG ≥ 14 s (50%vs9%, p = 0.001) as well as in patients with myosteatosis (33%vs6%, p = 0.03), but similar in patients with or without MHE (35%vs15%, NS). Conclusion: In cirrhotic patients both muscle alterations and cognitive impairment, as well as chronic beta-blockers use, are associated to the risk of falls.
2022
falls; minimal hepatic encephalopathy; myosteatosis; sarcopenia; timed up and go test
01 Pubblicazione su rivista::01a Articolo in rivista
Risk of falls in patients with cirrhosis evaluated by timed up and go test. Does muscle or brain matter more? / Nardelli, S.; Gioia, S.; Ridola, L.; Carlin, M.; Cioffi, A. D.; Merli, M.; Riggio, O.; Spagnoli, A.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - (2022), pp. 1-7. [10.1016/j.dld.2021.06.019]
File allegati a questo prodotto
File Dimensione Formato  
Nardelli_Risk-falls_2021.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 796.2 kB
Formato Adobe PDF
796.2 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1562038
Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 6
social impact