Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol

Introduction Myosteatosis, characterised by altered muscle composition detectable by muscle radiodensity attenuation on CT scans, has been associated with increased mortality in patients with cirrhosis. However, standard attenuation cut-offs, derived primarily from oncology populations, may not be a...

Full description

Saved in:
Bibliographic Details
Main Authors: Gennaro D'Amico, Manuela Merli, Aldo Montano-Loza, Simone Di Cola, Maryam Motamedrad
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e094252.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849388194797191168
author Gennaro D'Amico
Manuela Merli
Aldo Montano-Loza
Simone Di Cola
Maryam Motamedrad
author_facet Gennaro D'Amico
Manuela Merli
Aldo Montano-Loza
Simone Di Cola
Maryam Motamedrad
author_sort Gennaro D'Amico
collection DOAJ
description Introduction Myosteatosis, characterised by altered muscle composition detectable by muscle radiodensity attenuation on CT scans, has been associated with increased mortality in patients with cirrhosis. However, standard attenuation cut-offs, derived primarily from oncology populations, may not be appropriate for patients with cirrhosis. This study protocol aims to address this diagnostic gap by validating the Ebadi cut-offs, which are based on a retrospective cohort and have not been extensively validated in a cirrhotic population. The aim of the study is to refine these cut-offs for more accurate prediction of mortality in patients with cirrhosis using two independent patient cohorts (retrospective and prospective).Methods and analysis This post hoc validation study analyses muscle weakness cut-offs in patients with cirrhosis using data from two independent cohorts. A total of 1537 patients will be analysed. The study will assess interobserver variability to ensure robust results by analysing random samples of 60 patients from the two cohorts. Statistical methods will be used to determine the accuracy and relevance of current cut-offs in predicting patient mortality. The analysis will also examine the relationship between muscle wasting and clinical outcomes in cirrhosis and the relationship with muscle mass loss.Ethics and dissemination Ethical approval for this study has been obtained from the relevant institutional review boards. The results will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals. The results of the study are expected to contribute to improved diagnostic criteria for myosteatosis in cirrhosis, providing clinicians with more tailored and accurate tools for cirrhosis prognosis.Trial registration number NCT06593015.
format Article
id doaj-art-2009647dc20c46c48264d3e53fcac9a5
institution Kabale University
issn 2044-6055
language English
publishDate 2025-03-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-2009647dc20c46c48264d3e53fcac9a52025-08-20T03:42:22ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-094252Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocolGennaro D'Amico0Manuela Merli1Aldo Montano-Loza2Simone Di Cola3Maryam Motamedrad42 Gastroenterology, Ospedale V Cervello, Palermo, Italy1 Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Lazio, Italy3 Gastroenterology Division and Liver Unit, University of Alberta, Edmonton, Alberta, Canada1 Department of Translational and Precision Medicine, University of Rome La Sapienza, Rome, Lazio, Italy3 Gastroenterology Division and Liver Unit, University of Alberta, Edmonton, Alberta, CanadaIntroduction Myosteatosis, characterised by altered muscle composition detectable by muscle radiodensity attenuation on CT scans, has been associated with increased mortality in patients with cirrhosis. However, standard attenuation cut-offs, derived primarily from oncology populations, may not be appropriate for patients with cirrhosis. This study protocol aims to address this diagnostic gap by validating the Ebadi cut-offs, which are based on a retrospective cohort and have not been extensively validated in a cirrhotic population. The aim of the study is to refine these cut-offs for more accurate prediction of mortality in patients with cirrhosis using two independent patient cohorts (retrospective and prospective).Methods and analysis This post hoc validation study analyses muscle weakness cut-offs in patients with cirrhosis using data from two independent cohorts. A total of 1537 patients will be analysed. The study will assess interobserver variability to ensure robust results by analysing random samples of 60 patients from the two cohorts. Statistical methods will be used to determine the accuracy and relevance of current cut-offs in predicting patient mortality. The analysis will also examine the relationship between muscle wasting and clinical outcomes in cirrhosis and the relationship with muscle mass loss.Ethics and dissemination Ethical approval for this study has been obtained from the relevant institutional review boards. The results will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals. The results of the study are expected to contribute to improved diagnostic criteria for myosteatosis in cirrhosis, providing clinicians with more tailored and accurate tools for cirrhosis prognosis.Trial registration number NCT06593015.https://bmjopen.bmj.com/content/15/3/e094252.full
spellingShingle Gennaro D'Amico
Manuela Merli
Aldo Montano-Loza
Simone Di Cola
Maryam Motamedrad
Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol
BMJ Open
title Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol
title_full Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol
title_fullStr Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol
title_full_unstemmed Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol
title_short Study protocol to redefine muscle attenuation cut-offs for better prediction of mortality in patients with cirrhosis: a comprehensive post hoc validation study – a study protocol
title_sort study protocol to redefine muscle attenuation cut offs for better prediction of mortality in patients with cirrhosis a comprehensive post hoc validation study a study protocol
url https://bmjopen.bmj.com/content/15/3/e094252.full
work_keys_str_mv AT gennarodamico studyprotocoltoredefinemuscleattenuationcutoffsforbetterpredictionofmortalityinpatientswithcirrhosisacomprehensiveposthocvalidationstudyastudyprotocol
AT manuelamerli studyprotocoltoredefinemuscleattenuationcutoffsforbetterpredictionofmortalityinpatientswithcirrhosisacomprehensiveposthocvalidationstudyastudyprotocol
AT aldomontanoloza studyprotocoltoredefinemuscleattenuationcutoffsforbetterpredictionofmortalityinpatientswithcirrhosisacomprehensiveposthocvalidationstudyastudyprotocol
AT simonedicola studyprotocoltoredefinemuscleattenuationcutoffsforbetterpredictionofmortalityinpatientswithcirrhosisacomprehensiveposthocvalidationstudyastudyprotocol
AT maryammotamedrad studyprotocoltoredefinemuscleattenuationcutoffsforbetterpredictionofmortalityinpatientswithcirrhosisacomprehensiveposthocvalidationstudyastudyprotocol