To evaluate the value of the skeletal muscle index (SMI) and psoas major muscle index(PMI) measured at the third lumbar vertebra(L3) level in the evaluation on nutritional status and prognosis of cirrhosis patients with ascites.

The clinical data of 102 patients with cirrhosis and ascites treated in our department between September 2018 and September 2022 was analyzed retrospectively, the skeletal muscle and psoas muscle area at L3 level were measured, and L3-SMI and L3-PMI were calculated. According to L3-SMI, patients were divided into the sarcopenia group (62 cases) and the normal muscle mass group (40 cases). Differences between the two groups were compared in terms of L3-SMI, L3-PMI, body mass index (BMI), albumin, the rate of re-admissions and mortality during follow-up. The value of each index in nutritional assessment was also explored.

L3-SMI, L3-PMI, and albumin in the sarcopenia group were significantly lower than those in the normal muscle mass group, with statistical significance (P<0.01).The BMI of the sarcopenia group was lower than that of the normal muscle mass group, but the difference was not significant (P>0.05). L3-PMI showed better performance in nutritional assessment compared with albumin and BMI. The rate of re-admissions and the mortality rate in the sarcopenia group during the follow-up period were significantly higher compared with the normal muscle mass group (P<0.05).

L3-SMI and L3-PMI can effectively reflect the nutritional status of cirrhosis patients with ascites, and are promising indicators for prognosis prediction in cirrhosis patients with ascites.

Skeletal muscle index; Psoas major muscle index; Cirrhosis patients with ascites; Nutrition; Prognosis