Rectus femoris ultrasound as a rapid bedside tool associated with 1‐year hospitalization in cirrhosis: A retrospective study

BACKGROUND: Sarcopenia is a common complication of liver cirrhosis and is associated with adverse clinical outcomes, including increased hospitalization. Ultrasonography (USG) has recently emerged as a practical bedside method for assessing skeletal muscle mass. This study aimed to investigate the association between rectus femoris thickness (RFT) and rectus femoris cross-sectional area (RFCSA) measured by USG and hospitalization in patients with cirrhosis. METHODS: This retrospective, single-center study included 58 patients with cirrhosis followed at Hacettepe University Faculty of Medicine Hospital between August 2021 and April 2023. Demographic characteristics, clinical data, laboratory parameters, anthropometric measurements, and muscle USG findings were obtained from medical records. Patients were categorized according to hospitalization status. Multivariable logistic regression analyses were performed to identify independent factors associated with hospitalization. RESULTS: Patients with hospitalization had significantly lower body mass index and significantly higher Model for End-Stage Liver Disease sodium (MELD-Na) and Model for End-Stage Liver Disease 3.0 scores compared with those without hospitalization. RFT and RFCSA measured by USG were significantly lower in hospitalized patients (P = 0.011 and P = 0.032, respectively). In multivariable logistic regression analyses, RFT remained associated with hospitalization after adjustment for age, sex, and MELD-Na (OR, 0.78; 95% CI, 0.63-0.96; P = 0.021). Similarly, RFCSA was associated with hospitalization (OR, 0.73; 95% CI, 0.54-0.99: P = 0.043). MELD-Na score was also independently associated with hospitalization across the models. CONCLUSION: Ultrasound-based rectus femoris measurements were associated with hospitalization in patients with cirrhosis. Bedside assessment of RFT and RFCSA may serve as a practical complementary approach for identifying patients at higher risk of hospitalization.