title: The Royal Free Hospital-Nutritional Prioritizing Tool Is an Independent Predictor of Deterioration of Liver Function and Survival in Cirrhosis.
abstract: Malnutrition might affect survival and severity of complications in cirrhotic patients. However, adequate evaluation of the nutritional status is a difficult task since the common assessment tools are either inappropriate or too complicated. A simpler method could evaluate the patient's risk for malnutrition instead of the nutritional status itself. This study evaluated the prediction of clinical deterioration and transplant-free survival in patients with chronic liver disease by two nutritional risk scores.
  
  
  
  In 84 cirrhotic patients, Nutritional Risk Screening (NRS), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), and the chronic liver disease questionnaire have been assessed. These patients were evaluated at a second time point after a median observation time of 500 days. Another cohort of 64 patients was collected to validate the findings.
  
  
  
  Of the included patients, 67.7 % were male with a median age of 57 years and a median Child score of 9. RFH-NPT classified 50.7 % of the patients as high-risk patients, and NRS assessed 44.6 % of the patients as moderate- to high-risk patients. RFH-NPT correlated with clinical deterioration, severity of disease (Child score, MELD score), and clinical complications such as ascites, hepatorenal syndrome, and episodes of hepatic encephalopathy. RFH-NPT was an independent predictor of clinical deterioration and transplant-free survival. Furthermore, improvement in RFH-NPT within 500 days was associated with improved survival.
  
  
  
  Assessing the patients' risk for malnutrition by RFH-NPT may be a useful predictor of disease progression and outcome for patients with chronic liver disease.
authors.affiliation: Department of Internal Medicine I, University of Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
authors.forename: Sarah Maria
authors.initials: SM
authors.lastname: Borhofen
authors.affiliation: Center for Integrated Oncology (CIO), University of Bonn, Bonn, Germany.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gerner
authors.affiliation: Department of Internal Medicine I, University of Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lehmann
authors.affiliation: Institute of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.affiliation: Department of Internal Medicine I, University of Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Görtzen
authors.affiliation: Institute of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Hey
authors.affiliation: Institute of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Geiser
authors.affiliation: Department of Internal Medicine I, University of Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany.|Center for Integrated Oncology (CIO), University of Bonn, Bonn, Germany.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Strassburg
authors.affiliation: Department of Internal Medicine I, University of Bonn, Sigmund-Freud Str. 25, 53105, Bonn, Germany. jonel.trebicka@ukb.uni-bonn.de.
authors.forename: Jonel
authors.initials: J
authors.lastname: Trebicka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000178:diet therapy / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016019:Survival Analysis; D055815:Young Adult
keywords: CLDQ; Cirrhosis; NRS; Nutritional assessment; RFH-NPT