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Malnutrition is highly prevalent in hospitalized cirrhotic patients and associates with a poor outcome

Ahead of print available from 04/02/2022
These articles are scheduled for publication in Vol. 85 (2) 2021

Author(s) C. Dumont 1, F. Wuestenberghs 2, N. Lanthier 1, H. Piessevaux 1, G. Dahlqvist 1
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DOI10.51821/85.2.9016
Affiliations:
(1) Hepato-gastroenterology Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
(2) Université catholique de Louvain, CHU UCL Namur, Department of Gastroenterology and Hepatology, 5530 Yvoir, Belgium

Background and study aims: The role of malnutrition on the prognosis of hospitalized cirrhotic patients is incompletely studied. Our aim was to determine the prevalence of malnutrition, functional scores and their impact on prognosis of hospitalized cirrhotic patients.

Patients and methods: This retrospective study included all patients with cirrhosis hospitalized in the gastroenterology unit at Saint-Luc university hospital, Brussels between April 2014 and September 2014. Nutritional status was evaluated according to minimum clinical summary diagnostic criteria. Cirrhosis-related complications or death occurrence were analysed in a one-year follow-up.

Results: 95 cirrhotic patients were assessed for nutritional status and outcomes. Malnutrition affected 45.3% of patients and was more frequent with the severity of cirrhosis: 29% in Child-Pugh A, 48.8% in Child-Pugh B and 72.2% in Child-Pugh C patients. 58.9% of patients developed cirrhosis-related complications (60.7% in the malnutrition group vs. 39.3%, p<0.001, OR 5.06, IC95 1.90-14.58) and 33.7% of patients died (68.75% vs. 31.25%, p=0.002, OR 4.33, IC95 1.62-12.28). Adjusting for age, sodium, MELD, Charlson index, hepatocellular carcinoma, platelets, diabetes, prognostic nutritional index and Braden scale, malnutrition was significantly associated with higher mortality and morbidity rates with an OR of 3.56 (CI95 1.55-8.16) and 2.09 (CI95 1.16-3.77) respectively. Braden scale was significantly associated with higher mortality (p=0.027, OR 1.25, CI95 1.03-1.52) whereas prognostic nutritional index was associated with higher morbidity (p=0.001, OR 0.94, CI95 0.90- 0.98).

Conclusion: Malnutrition is highly prevalent in hospitalized cirrhotic patients. Malnutrition, low prognostic nutritional index and low Braden scale are associated with poor outcomes in cirrhosis.

Keywords: alcoholic liver disease, cirrhosis, nutrition, prognosis, malnutrition
The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.