Study of Comparison of Handgrip Dynamometer and Transverse Psoas Muscle Thickness as a Predictor of Short-term Morbidity and Mortality in Patients of Chronic Liver Disease

Aims and background: Sarcopenia is a common complication in chronic liver disease (CLD) and is associated with increased morbidity and mortality.Tools like handgrip dynamometry (HGD) and transverse psoas muscle thickness (TPMT) have emerged for assessing sarcopenia, but comparative data on their prognostic performance are limited, especially in Indian populations.To compare the prognostic performance of HGD and TPMT in predicting 90-day morbidity (hospital stays, readmissions) and mortality in CLD patients; to validate sex-specific TPMT cutoffs for sarcopenia assessment in an Indian CLD cohort; and to examine the correlation of HGD and TPMT with the model for end-stage liver disease-sodium (MELD-Na) scores to enhance risk stratification and guide personalized interventions. Materials and methods:A prospective observational study was conducted on 88 adult CLD patients.Handgrip dynamometry and computed tomography (CT)-based TPMT measurements were taken.Patients were followed for 90-day for outcomes including mortality, readmissions, and hospital stay duration.Receiver operating characteristic (ROC) analysis and multivariate logistic regression were used to evaluate predictive performance.Results: Transverse psoas muscle thickness was a better predictor of mortality [cutoff: 13 mm/m, sensitivity 80%, specificity 70%, area under the curve (AUC) = 0.697, p = 0.038], while HGD showed higher sensitivity for readmission (cutoff: 13 kg, sensitivity 90%, AUC = 0.836, p < 0.001).Both measures correlated with longer hospital stays and higher MELD-Na scores.Transverse psoas muscle thickness and HGD were not independent predictors of mortality in multivariate analysis. Conclusion:Transverse psoas muscle thickness outperforms HGD in predicting mortality, while both are effective for readmission risk.Incorporating TPMT into routine CLD assessments may improve short-term prognostication. Clinical significance:• Transverse psoas muscle thickness better predicts 90-day mortality in CLD patients.• Handgrip dynamometry is more sensitive for predicting hospital readmission risk.• Both TPMT and HGD correlate with higher MELD-Na and longer hospital stays.• Transverse psoas muscle thickness and HGD are not independent mortality predictors in multivariate analysis.• Sex-specific TPMT cutoffs validated for Indian CLD patients.