The use of clinical and biochemical tools of nutritional status assessment in predicting the course of liver cirrhosis

Abstract

Malnutrition is a common complication of liver cirrhosis (LC) and is associated with a poor prognosis. Optimal tools for monitoring the nutritional status in LC have not been determined. The aim of the work was to evaluate the diagnostic agreement and prognostic value of the Nutritional Risk Index (NRI) and the Controlling Nutritional Status (CONtrolling NUTritional status, CONUT) score in LC patients. Materials and methods. 161 LC patients (mean age 55.2 ± 11.6 years) were included. 23 patients had LC class A, 57 – class B, and 81 – CTP class C. During the follow-up period (median 489 (interquartile range 293–639) days), 50 patients died of LC complications. The nutritional status of patients was assessed according to the CONUT score and the NRI. The results. Moderate and severe malnutrition was found in 95 and 83 % of class C LC patients according to NRI and CONUT, respectively. Diagnostic agreement between NRI and CONUT was weak (k = 0.306, p ˂ 0.001). The numerical CONUT score predicted the long-term mortality of patients (AUC 0.771, p ˂ 0.001) with an optimal cut-off ≥ 7 points. NRI had a worse predictive ability (AUC 0.673, p ˂ 0.001). Conclusion. The Controlling Nutritional Status (CONUT) score is an acceptable tool for diagnosing malnutrition in LC patients and can predict the long-term mortality of patients. The Nutritional Risk Index (NRI) has low diagnostic agreement with CONUT and lower predictive value.