Nutritional status and prognosis in cirrhotic patients.
OBJECTIVE
Malnutrition is commonly associated with chronic liver disease. The presence of protein-calorie malnutrition has been shown to be associated with increased short- and long-term mortality in patients with acute and chronic liver disease. We undertook this study to assess the prognostic value of nutritional status in predicting survival in cirrhotic patients. The aim of our study was to determine whether assessment of nutritional status using the RFH-SGA score adds significantly to CP (Child-Pugh) and MELD scores in predicting patient prognosis and survival in cirrhotic patients.


METHODS
Diagnosed cases of cirrhosis were enrolled and their nutritional assessment was done using the RFH-SGA score. All patients were followed up for a period of 6 months. The mortality rates in the various groups were compared with respect to their nutritional status. Multivariate analysis was used to determine the factors associated with mortality.


RESULTS
A total of 73 cirrhotic patients were taken up for this study. Of these, 23 patients (31.5%) were well nourished, 21 (28.8%) had mild to moderate malnourishment and 29 (39.7%) were severely malnourished. Multivariate analyses of various parameters identified poor nutritional status, increased CP grade, increased creatinine, lower sodium levels and longer prothrombin time as being independently associated with poorer survival.


CONCLUSIONS
RFH-SGA is a simple and inexpensive tool for assessing the nutritional status in cirrhotic patients and can reliably predict their disease prognosis and survival.
Department of Gastroenterology and Hepatology, TNMC-BYL Nair Hospital, Mumbai, India.
Madhu
M
Sasidharan
Srinivas
S
Nistala
R T
RT
Narendhran
M
M
Murugesh
Shobna J
SJ
Bhatia
Pravin M
PM
Rathi
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D055815:Young Adult