To study prevalence of Sarcopenia in a patients with decompensated liver cirrhosis in tertiary care hospital

The study will be conducted only after a clearance is obtained from the local ethical committee of Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha by submitting a synopsis mentioning all the proposed study details and protocols.

It is Observational Prospective Study

The study will be conducted in Acharya Vinoba Bhave rural Hospital (AVBRH), a tertiary care teaching hospital situated in the rural area of Wardha District. The aforementioned hospital, AVBRH, is a 1500+ bedded teaching hospital providing healthcare to the rural people of central India. Detailed history and physical examination will be performed.

Below tests are done for sarcopenia.

CT scan will be done to look for skeletal muscle index at 3rd lumbar vertebrae.

It is the only modality that has validated sex- specific cut-offs, notably <50 cm2/m2 in men and <39 cm2/m2 in women.

Mid-arm muscle circumference (MAMC): MAMC (in cm) is obtained by measuring the mid-arm circumference (MAC; in cm) and tricep skinfold (TSF; in mm). These measures are cheap, quick and can be safely used in routine clinical practice to assess repeated measures of sarcopenia.

Muscle strength :The most frequently used modality is hand grip strength

(HGS) as it is simple and can be used for repeated measures.

It is recommended by the recent European guidelines in the assessment of patients with cirrhosis. HGS has been shown to be

a better predictor of adverse clinical outcomes than CT measures of muscle mass and model for end-stage liver disease (MELD).

Muscle function :Short Physical Performance Battery (SPPB) consists of chair stands, gait speed and balance (each scored out of 4; with a maximal score of 12) and a score <10 increases the odds of mortality by 2.5

 Liver Frailty Index (LFI):It replaces gait speed with HGS and is sub-categorised into frail (>4.4), pre-frail (3.2 - 4.4) and robust (<3.2).

Aerobic exercise capacity:This relies on muscle function, and can be assessed using the easy-to-apply, objective 6-minute walk distance (6MWD) or the more expensive, time-consuming cardiopulmonary exercise test (CPET).A 6MWD of less than 250 m represents poor muscle function/exercise capacity and is associated with two-fold increased mortality in patients on the transplant waiting list.