Nutritional assessment of cirrhotic patients with variable severity

Abstract

Introduction Malnutrition presents in more than half of cirrhotic patients. It is varied from 20% in compensated liver disease to 80% in decompensated liver disease. This study aimed at assessing the frequency of malnutrition and relation between the malnutrition and degree of liver severity. Patients and methods This study was carried out in Tropical Medicine and Gastroenterology Department at El-Rajhy Hospital in Assiut University, Egypt, from December 2015 to December 2016 on 101 patients diagnosed with liver cirrhosis. Based on their medical profile, the liver disease severity was determined by Child–Pugh, model for end-stage liver disease, and model for end-stage liver disease sodium scores, then nutritional status of the patients was assessed by different methods including anthropometric diameters (BMI, triceps skinfold thickness, mid-arm circumference, and mid-arm muscle circumference), body composition analysis, subjective global assessment, creatinine–height index, prognostic nutritional index (PNI), and controlling nutritional status (CONUT), and finally, we assessed the relation between the nutritional status and the severity of liver disease. Results The frequency of malnutrition among the studied patients varied from 25.7% by BMI to 98% by PNI and CONUT. There was difference in degree of malnutrition between the different groups of liver disease; however, this variation was not significant when anthropometric measures and body composition analysis were used but was statistically significant when subjective global assessment, creatinine–height index, PNI, and CONUT were used. Conclusion The nutritional status of cirrhotic patients is an important tool, together with Child and model for end-stage liver disease scores, for the prediction of prognosis of such patients. All the nutritional assessment tools are needed together with no substitution of one method by another for precise assessment of malnutrition among cirrhotic patients.