Abstract
Background: Echinococcosis is a chronic consumptive liver disease. Little research has been carried out on the nutritional status of infected patients, though liver diseases are often associated with malnutrition. Our study investigated four different nutrition screening tools, to assess nutritional risks of hospitalized patients with echinococcosis. Methods: Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the Nutrition Risk Index (NRI) were used to assess 164 patients with alveolar echinococcosis (AE) and 232 with cystic echinococcosis (CE). Results were then compared with European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition diagnosis. Results: According to ESPEN standards for malnutrition diagnosis, 29.2% of CE patients and 31.1% of AE patients were malnourished. The malnutrition risk rates for CE and AE patients were as follows: NRS 2002 – 40.3% and 30.7%; MUST – 51.5% and 50.9%; MNA-SF – 46.8% and 44.1%; and NRI – 51.1% and 67.4%. In patients with CE, MNA-SF and NRS 2002 results correlated well with ESPEN results (k = 0.515, 0.496). Area-under-the-curve (AUC) values of MNA-SF and NRS 2002 were 0.803 and 0.776, respectively. For patients with AE, NRS 2002 and MNA-SF results correlated well with ESPEN (k = 0.555, 0.493). AUC values of NRS 2002 and MNA-SF were 0.776 and 0.792, respectively. Conclusion: This study is the first to analyze hospitalized echinococcosis patients based on these nutritional screening tools. Our results suggest that NRS 2002 and MNA-SF are suitable tools for nutritional screening of inpatients with echinococcosis.
Highlights
Studies on malnutrition associated with other liver diseases have shown that patients with malnutrition experience higher rates of infection, morbidity and mortality compared to patients without malnutrition [16]
No significant differences were observed between the cystic echinococcosis (CE) patients with and without malnutrition for gender, height, HGB, LYMPH, stage, and number of comorbidities (p > 0.05)
There were no significant differences between the alveolar echinococcosis (AE) patients with and without malnutrition for age, gender, height, LYMPH, and number of comorbidities (p > 0.05)
Summary
Because of its insidious and asymptomatic early stages, the diagnosis and treatment of echinococcosis is complex, and the disease has a high mortality rate in its late stages. We often find echinococcosis patients with malnutrition in the clinical diagnosis and treatment process. No previous studies have analyzed and evaluated the nutritional status of patients with echinococcosis (as of the start date of this study). NRS2002 [11], MUST [15], MNA-SF [14] and NRI [5, 7] were used to investigate the nutritional status of hospitalized patients with echinococcosis. Through a comprehensive comparative analysis of the four methods, a suitable nutritional evaluation program was selected for patients with echinococcosis to provide a reference for clinical practice
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