Effect of nutrition on prognosis of Egyptian cirrhotic patients

Abstract

Malnutrition is a common complication of end-stage liver disease, by far the easiest methods to differentiate compensated and uncompensated liver cirrhosis are the Child–Pugh and MELD score. These methods have omitted under nutrition from their scoring. Present study is aimed to study the effect of malnutrition among Egyptian cirrhotic patients on the prognosis and mortality. 300 Egyptian cirrhotic patients, laboratory and nutritional assessment were done according to RFH-SGA, measurement of BMI, TST, and MAMC. Each patient was assigned a Child and MELD score and all patients were followed up for six months. 49 patients (16.3%) died throughout the follow up. 57(19%) were severely malnourished. 134 (44.66%) and109 (36.33%) were well nourished and moderately malnourished, respectively. 63.4% of non-survivors were malnourished (p=0.001). A higher MELD score in non-survivors (29.8) than that of survivors (21.7) (P=0.007). Increase the TST (triceps skinfold thickness) in survivors (10.1mm i.e. less than 50 th percentile) than in non-survivors (5.9mm i.e. less than 5 th percentile) (P=0.003). The MAMC (midarm muscle circumference) was 24.5cm (i.e. 10 th percentile) and 19.4cm (i.e. less than 5 th percentile) in survivors and non-survivors, respectively (P=0.002). The nutritional status of cirrhotic patients is an important tool, together with MELD and Child score, to predict the prognosis of such patients and the severity of malnutrition is associated with higher mortality, early referral of cirrhotic patients with bad nutritional status for transplantation is recommended.