Letter: patients who have both sarcopenia and frailty have similar prognosis to those with either condition separately

This article is linked to Bunchorntavakul & Reddy papers. To view these articles, visit https://doi.org/10.1111/apt.15571 and https://doi.org/10.1111/apt.16581 We read with interest the review by stating that ‘there a strong interplay between malnutrition, sarcopenia, physical deconditioning frailty in liver cirrhosis’.1 Sarcopenia are associated bad outcomes cirrhosis independent of disease severity.1-4 However, few studies evaluated impact their coexistence on mortality.5-7 aimed better understand interconnection sarcopenia frailty, investigate mortality patients cirrhosis. included 115 consecutive (72.2% male; median age 59 years [IQR 52-67]; MELD 12 [8-16]; 71.3% decompensated cirrhosis). Mortality was recorded at 360 days. diagnosed according latest European Working Group Older People (EWGSOP-2) criteria.8 Frailty calculating Liver Index (LFI).9, 10 without or were 21 (group A) (11 [9.6%] [8.7%], respectively). Both coexisted 29 (25.2%) B). Sixty-five (56.5%) had neither nor C—reference group). B older than groups A C (median 69 [interquartile range 62.5-73.5], [53-64] 56 [51-63] respectively; P < 0.001). more severe group C. Decompensated encountered 96%, 80.9% 56.9% (P 0.001), score 16.0 (12.5-22.0), 13.0 (8.0-21.5) 10.0 (8.0-14.0) 0.001) Groups B, respectively. higher rate days (58.6%) (38.1%) (10.8%) (log rank (Figure 1). The Cox regression multivariable analysis demonstrated similar cumulative survival against after adjustment for age, sex (dichotomized as ≥15 <15) (HR 3.58 [95% CI 1.37-9.3], = 0.009 HR 3.34 1.18-9.51], 0.024 prevalent advanced Either conditions present 43.5% they about 25.2%. high two showed inter-related. finding partially expected since handgrip strength one diagnostic components used both diagnosis. Moreover, muscle function inter-dependent so low mass usually implies impaired function. In conclusion, there risk those either increased when coexisted. severity disease, concordance rates compared condition separately. Declaration personal interests: None.