{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:53:00Z","timestamp":1791557580421,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Sarcopenia is a major determinant of adverse outcomes in cirrhosis, yet CT\u2010 and MRI\u2010based assessments are difficult to implement in routine and longitudinal practice. Ultrasound is a feasible bedside alternative, but its prognostic role remains unclear. We performed a systematic review to evaluate the association between ultrasound\u2010derived skeletal muscle measures and mortality in adults with cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review followed PRISMA guidelines and was registered in PROSPERO (CRD420251056162). MEDLINE, Scopus, Web of Science and the Cochrane Library were searched to October 2025. Prospective studies assessing ultrasound\u2010based muscle parameters and mortality in cirrhosis were included. Risk of bias was evaluated using QUIPS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six prospective studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009731) were included. Heterogeneity in muscle sites, ultrasound protocols, indexation methods, sarcopenia definitions and outcomes precluded meta\u2010analysis. Lower ultrasound\u2010derived muscle measures were consistently associated with higher mortality. In acute decompensation, reduced rectus femoris area predicted 90\u2010day mortality (sHR 0.57; 95% CI 0.38\u20130.85). Rectus abdominis thickness and psoas indices were also associated with mortality. In hospitalized decompensated cirrhosis, ultrasound\u2010defined sarcopenia was strongly associated with 6\u2010month mortality (HR 6.37; 95% CI 3.15\u201312.87). In critically ill liver transplant candidates, higher serial rectus femoris muscle area measurements were associated with better survival. In advanced chronic liver disease, sarcopenia was linked to increased 1\u2010year mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our systematic review, ultrasound\u2010based muscle measures demonstrated a broadly consistent association with mortality; although not yet fully validated, they represent a promising bedside prognostic tool. Standardization is needed before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70891","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:20:33Z","timestamp":1789730433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound\u2010Based Skeletal Muscle Assessment for Prognostication in Cirrhosis: A Systematic Review"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6414-4404","authenticated-orcid":false,"given":"Simone","family":"Di Cola","sequence":"first","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8292-1134","authenticated-orcid":false,"given":"Paolo","family":"Gallo","sequence":"additional","affiliation":[{"name":"Clinical Medicine and Hepatology Unit Fondazione Policlinico Universitario Campus Bio\u2010Medico  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-2217","authenticated-orcid":false,"given":"Jakub","family":"Gazda","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine Pavol Jozef Safarik University and L Pasteur  Ko\u0161ice Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8883-4604","authenticated-orcid":false,"given":"Saniya","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6761-4969","authenticated-orcid":false,"given":"Lucia","family":"Lapenna","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Gioia","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Nardelli","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Vespasiani\u2010Gentilucci","sequence":"additional","affiliation":[{"name":"Clinical Medicine and Hepatology Unit Fondazione Policlinico Universitario Campus Bio\u2010Medico  Roma Italy"},{"name":"Research Unit of Clinical Medicine and Hepatology, Department of Medicine and Surgery Universit\u00e0 Campus Bio\u2010Medico di Roma  Roma 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