Abstract
Nutritional status of patients in the waiting list for liver transplant must be assessed due to the many risk factors associated with nutritional deficiencies. This was the aim of the study. Throughout a period of 13 months, patients on the waiting list for liver transplantation were nutritionally assessed by the Subjective Global Assessment (SGA) and food intake was assessed by using the 24 hour recall instrument. 159 patients were included, mean age 50.5 +10.6 years and 71.1% were men. Overall malnutrition according to SGA was 74.7%, with 28% of patients considered severely malnourished. Malnutrition was associated with Child-Pugh score, presence of ascites and/or edema, previous episodes of encephalopathy and use of three or more medications and lower levels of physical activity. Socio-economic aspects, etiology of the disease and MELD score did not affect the nutritional status (p = NS). Calorie needs were not reached by 90.7% of patients and 75.7% of them did not reach protein requirements. In conclusion, malnutrition is highly prevalent amongst patients on the waiting list for liver transplantation and most do not meet nutritional requirements which certainly contribute to the vicious cycle leading to a deranged nutritional status.
Highlights
Malnutrition is highly prevalent amongst patients on the waiting list for liver transplantation and most do not meet nutritional requirements which certainly contribute to the vicious cycle leading to a deranged nutritional status. [Rev Assoc Med Bras 2009; 55(4): 389-93]
A prospective study of preoperative nutritional supplementation in patients awaiting elective orthotopic liver transplantation
Summary
- Avaliação global subjetiva (AGS) A AGS8 baseia-se na história clínica e no exame físico. Em relação ao estado nutricional, pacientes considerados desnutridos ingeriram 89% e 78,8% abaixo das necessidades calculadas, respectivamente, para calorias e proteínas. Outros autores já haviam afirmado não haver relação entre desnutrição e etiologia da doença hepática[22] embora alguns estudos[18,23] mostraram que pacientes com cirrose etanólica têm pior estado nutricional. A gravidade da doença hepática, avaliada no presente estudo pelo escore de Child-Pugh, presença de edema e/ou ascite, episódio de encefalopatia hepática e número de medicamentos, afeta o estado nutricional dos pacientes. Tabela1 - Estado nutricional versus critérios de gravidade ChildPugh e MELD, complicações (encefalopatia, edema e/ou ascite), número de medicamentos e atividade física de pacientes em lista de espera para transplante hepático, Belo Horizonte, 2008
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