[Prevalence of Malnutrition in Patients with Liver Cirrhosis: An Observational Study]
María Cielo Gutiérrez1, Andrea Curia1, Enzo Rey1
1División de Gastroenterología. Hospital de Clínicas José de San Martín, Universidad de Buenos Aires. Ciudad Autónoma de Buenos Aires, Argentina. Universidad de Buenos Aires División de Gastroenterología Hospital de Clínicas José de San Martín Universidad de Buenos Aires Ciudad Autónoma de Buenos Aires Argentina.
Introduction:
Malnutrition is a frequent entity in patients with liver cirrhosis and has a negative impact on mortality.
Aim:
To describe the prevalence of malnutrition by means of subjective global assessment and anthropometry in patients with liver cirrhosis, and to analyze its relationship with the severity and etiology of the disease.
Methods:
We included patients > 18 years with liver cirrhosis, ambulatory or hospitalized, consecutively between May 2016 and April 2019; they underwent nutrition evaluation through subjective global assessment and anthropometry. Muscle strength was measured by dynamometry. Child-Pugh and MELD severity scores were evaluated. Statistical analysis: Chi-square test or Fisher's exact test and Mann-Whitney test. The statistical significance value was p <0.05.
Results:
A total of 436 patients (50.2% women) were evaluated, age 59.6 ± 13 years, CP A 69.3%, B 22.2% and C 8.5%, MELD ≥15 points 12.8%.subjective global assessment and anthropometry were normal in 46.3% of the cases. The absolute concordance between subjective global assessment and anthropometry was 59.2% (kappa = 0.25); 49.5% of the patients presented some degree of malnutrition by subjective global assessment and 26.1% by anthropometry. This condition was diagnosed by aforementioned assessment in 36.1%, 77.3%, 86.5% in CP A, B and C, respectively, while by anthropometry, malnutrition was diagnosed in 20.5% of those with CP A, in 33% with CP B and in 54% with CP C. A significant association was also found according to the MELD score by anthropometry and subjective global assessment (p < 0.0001). Patients with alcoholic etiology presented greater malnutrition.
Conclusion:
Malnutrition is common in patients with liver cirrhosis, with a high prevalence in compensated patients. The concordance between subjective global assessment and anthropometry was low, so the complementary use of subjective and objective tools would be convenient. Early detection of malnutrition would allow timely intervention.
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