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Subject Area

Community Medicine and Public health

Article Type

Original Study

Abstract

Background Protein-energy malnutrition is very common in cirrhosis and associated with increased risk of mortality and morbidity. Simple bedside parameters to identify malnutrition are essential to diagnose and manage the nutritional deficit early to improve the prognosis of cirrhotic patients. This study aims to assess the nutritional status of hepatic cirrhotic patients using different tools to determine the prevalence of malnutrition among them, and to compare the different used methods of assessment. Patients and methods This is a cross-sectional study, conducted at the National Liver Institute, Menoufia University. All patients are adults with cirrhotic liver. Nutritional status assessment was conducted through five methods: subjective global assessment (SGA), BMI, arm muscle area measurement, hand-grip strength, and bioelectrical impedance analysis (BIA). Results In total, 460 patients (374 males and 86 females) with mean age 56.8 ± 9.4 years were included in the study. Hepatitis B/C-virus infection was the main cause of cirrhosis in 87.8% of them. Nearly half of them (55.9%) were Child–Pugh class A. The percentage of malnutrition ranged from 10.7% using modified BMI to 64.6% using phase angle. In comparison with Child–Pugh score, all methods showed statistical significance (P < 0.05). Comparison of nutritional assessment tools with Child–Pugh score showed that SGA has the highest sensitivity (83%), followed by phase angle of BIA (65%). Conclusion Nutritional assessment of cirrhotic patients is challenging due to the presence of edema, and the absence of a validated gold standard. This study revealed marked discrepancies between different methods of nutritional assessment of cirrhotic patients. SGA followed by BIA were the best-used measures in relation to Child–Pugh scoring system.

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