Assessment of Severity of Liver Cirrhosis and Nutritional status of Cirrhotic patients in Tribhuvan University Teaching Hospital, Kathmandu

Abstract

Malnutrition is common in chronic liver disease. The general objective of this study was to assess severity and nutritional status of cirrhotic patients in Tribhuvan University Teaching Hospital (TUTH). A cross-sectional study was carried out among 88 cirrhotic patients of age group of ≥18 years. Information regarding general profile of patient, Child Turcotte Pugh score (CTP), Model for End Stage Liver Diseases-Na Score ( MELD-Na), Subjective Global Assessment (SGA), Mid Arm Circumference (MAC), Triceps Skin Fold Thickness (TST), Mid Arm Muscle Circumference (MAMC) and Functional Assessment: Handgrip Strength (HGS) was collected. SPSS version 20 was used to analyse data. Majority (56.8%) belonged to CTP grade C, 31.8% belonged to CTP grade B and 11.4% patients belonged to CTP grade A. Majority, 72.7%, 71.6% and 65.9% were malnourished when assessed using SGA, TST and MAC respectively. Majority, 86.4% of the patients had impaired handgrip strength. SGA, TST, MAC and HGS were significantly associated with CTP whereas no any statistically significant association was found between Child-Pugh and MAMC. There was statistically significant difference among the MELD Na means among SGA and HGS classes. The mean MELD Na scores did not significantly differ between among the TST, MAC and MAMC classes. The early diagnosis of the nutritional state and the treatment of malnutrition in cirrhotic patients can contribute to a reduction in the frequency and/or severity of these complications. SGA, TST, MAC and HGS are the non-invasive and easy methods of nutritional assessment of cirrhotic patients to use in regular clinical practice at bed side.