Development and Evaluation of Nutrition Screening Tool in Patients with Hepatitis B-Related Cirrhosis: A
Suzhen Chen1, Hong Li2, Xiuru Lin3
1Department of Hepatology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.
Aim:
Malnutrition is common in cirrhotic patients; however, there is no gold standard for nutritional assessment for this population. The aim of this study was to develop a novel nutritional screening tool based on objective indicators for cirrhotic patients chronically infected with hepatitis B virus (HBV).
Methods:
This was a cross-sectional study. Patients with hepatitis B-related cirrhosis were recruited. Malnutrition was diagnosed by the presence of any of the following conditions: Nutrition Risk Screening 2002 score greater than 3 points, Subjective Global Assessment grade B or C, and body mass index (BMI) <18.5 kg/m2. Nomogram model and decision tree model were developed, and the area under the receiver operating characteristic curve (AUROC) was compared.
Results:
Among the 231 studied cases, 92 (39%) were malnourished. Malnourished patients had significantly lower serum albumin, BMI and hand grip strength levels, but higher serum creatinine level and Child-Pugh grade. Two models were developed based on these variables. The nomogram model had a sensitivity of 0.696, a specificity of 0.820 and an accuracy of 0.813. The AUROC of nomogram model was 0.813 (95% CI: 0.758-0.869, p <0.001). For the decision tree model, the sensitivity, specificity and accuracy are 0.761, 0.885 and 0.886, respectively, with an AUROC of 0.886 (95% CI: 0842-0.930, p <0.001). The difference in AUROC between these two models was not statistically significant (p <0.001).
Conclusion:
The nomogram model and decision tree model developed in this study may aid assessing nutritional status for cirrhotic patients with HBV.
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