AbstractBackground and AimSarcopenia and severe vitamin D deficiency are associated with malnutrition and poor prognosis. We investigated the impact of the comorbidity of Child–Pugh (CP) class B/C cirrhosis and the aforementioned complications on the prognosis of patients with cirrhosis.MethodsWe retrospectively evaluated 104 patients with cirrhosis. The cumulative survival rates were compared between patients with and without both or either of these disease conditions: CP class B/C and complications (sarcopenia or severe vitamin D deficiency). Sarcopenia was diagnosed according to the Japan Society of Hepatology criteria. Severe vitamin D deficiency was defined as levels of 25‐hydroxyvitamin D <10 ng/mL in serum.ResultsThe prevalence of CP class B/C, sarcopenia, and severe vitamin D deficiency was 26.9%, 38.5%, and 24.0%, respectively. Patients with both CP class B/C and sarcopenia had significantly lower survival rates than those without both (hazard ratio [HR] = 6.101;P< 0.001) and with either condition (HR = 6.137;P= 0.001). Similarly, patients with both CP class B/C and severe vitamin D deficiency or with either condition had significantly lower survival rates than those without both conditions (HR = 8.135 or 3.189;P< 0.001 or =0.025, respectively). CP class B/C (HR = 3.354;P= 0.006) and severe vitamin D deficiency (HR = 2.445;P= 0.044) were independent prognostic factors.ConclusionsThe coexistence of CP class B/C and sarcopenia or severe vitamin D deficiency worsened the prognosis of patients with cirrhosis. Nutritional assessments such as sarcopenia and vitamin D status should be considered to better evaluate disease conditions and patient prognosis.