{
  "abstract": "Introduction Socioeconomic deprivation is known to be associated with poor outcomes in liver disease, but its relationship with frailty, sarcopenia and mental health in decompensated cirrhosis is incompletely understood.Methods 83 patients attending a decompensated cirrhosis clinic at a non-transplant tertiary liver centre (2023-2025) were included. Socioeconomic status was assigned using the English Index of Multiple Deprivation (IMD25), analysed as a continuous rank by Lower-layer Super Output Area (lower rank = greater deprivation) and dichotomised into the most deprived quintile, versus others (quintiles 2-5).Frailty was assessed using the Liver Frailty Index (LFI), muscle function using hand-grip strength (HGS) and muscle mass with CT-derived psoas muscle index (PMI, psoas muscle area indexed to height). Sex-specific PMI cut-offs were derived from the literature. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Associations were explored using Spearman’s rank correlation and Mann-Whitney U tests. Secondary analyses included disease severity and aetiology. Exploratory mortality analysis was performed.Results Mean age was 63±10 years; 54% patients were men. Median MELD was 13 (IQR 10-17), 18% patients had Child-Pugh C cirrhosis. 73% had alcohol-related liver disease. 48% patients were from the most deprived IMD quintile. 54/80 (68%) patients with LFI data were frail. CT-defined sarcopenia (low PMI) was present in 27 (44%) of 62 patients with recent imaging. 13/45 (29%) patients who completed the HADS had scores in the clinical range.IMD rank was not correlated with LFI (ρ = −0.07, p = 0.53, n = 80), HGS (ρ = −0.10, p = 0.36, n = 86) or PMI (ρ = 0.07, p = 0.59, n = 62). Findings were consistent when comparing the most deprived quintile with all other quintiles. Among patients with available HADS data (n = 45), greater deprivation was associated with higher anxiety (ρ = −0.30, p = 0.049) and depression (ρ = −0.29, p = 0.052) scores. HADS was not associated with LFI, HGS or PMI. IMD was not associated with disease severity. Analyses restricted to patients with alcohol-related liver disease yielded similar findings.Exploratory analysis of 12-month mortality (n = 16) suggested a trend towards higher mortality in the most deprived quintile versus less deprived (27% vs 11%, p = 0.095), consistent with Kaplan-Meier analysis.Conclusions In this cohort with a high burden of socioeconomic deprivation and alcohol-related liver disease, deprivation was associated with psychological distress but not objective measures of frailty or sarcopenia. The impact of deprivation may be attenuated in patients with established decompensation. Deprivation-related disparities in outcomes are likely to be driven by wider structural or social determinants of health.",
  "authors": [
    {
      "affiliations": [
        "Manchester Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Miran Faily"
    },
    {
      "affiliations": [
        "Manchester Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Mareen Zachariah"
    },
    {
      "affiliations": [
        "Manchester Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Katherine Martin"
    },
    {
      "affiliations": [
        "Manchester Foundation Trust, Manchester, United Kingdom"
      ],
      "name": "Selena Dixon"
    }
  ],
  "title": "P113 Impact of socioeconomic deprivation on frailty, sarcopenia and mental health in patients with decompensated cirrhosis",
  "uid": "7b43b172-b332-5add-9d1e-bc4d533fdb85"
}