Nutritional status and the performance of multiple bedside tools for nutrition assessment among patients waiting for liver transplantation: A Canadian experience

详细信息    查看全文

• 作者：Kaleb J. Marr^a ; ¹ ; Abdel-Aziz Shaheen^a ; ¹ ; Louisa Lam^b ; Melanie Stapleton^c ; Kelly Burak^c ; Maitreyi Raman^c ; ^{mkothand@ucalgary.ca}
• 关键词：Malnutrition ; Cirrhosis
• 刊名：Clinical Nutrition ESPEN
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：17
• 期：Complete
• 页码：68-74
• 全文大小：235 K
• 卷排序：17

文摘

Malnutrition is an important predictor of morbidity and mortality among cirrhotic patients. Our objectives were to assess protein-calorie malnutrition (PCM) in cirrhotic pre-liver transplant patients and to study the correlation between subjective global assessment (SGA) and other objective measures of malnutrition.MethodsWe recruited pre-liver transplant adult patients at our center between October 2012 and Oct 2015. Nutrition status was assessed via SGA. PCM was assessed by comparing recommended to actual protein and calorie intake. SGA was correlated with body mass index (BMI), dry BMI, handgrip strength by calibrated dynometer (HGS), and mid-arm circumference (MAC). We used non-parametric statistical methods in our analysis.ResultsSeventy patients were included in this study. Majority were males (n = 46, 66%) with a median age of 58 years (IQR: 50-61). Moderate to severe malnutrition was prevalent in our cohort (SGA-A: n = 15 (21.4%), SGA-B: n = 30 (42.9%) and SGA-C: n = 25 (35.7%). There was a significant difference in the recommended calories consumed between SGA groups (A 98.5% vs. C 79.2%, P = 0.03). A similar trend was observed for the recommended protein consumed (A 85.4%, C 62.5%; P = 0.09). SGA correlated with BMI (A = 26.4, C = 22.4; P<0.01), Dry BMI (A = 25.9, C = 20.4; P<0.01), HGS (A = 67.0, C = 47.0 PSI; P = 0.03), and MAC (A = 29.5 cm, C = 22.0 cm; P<0.01). HGS and MAC were strongly correlated (Spearman correlation 0.49, P<0.01).ConclusionsCirrhotic patients have significant protein-calorie malnutrition. Multiple malnutrition tools including BMI, dry BMI, HGS and MAC were precisely able to assess malnutrition.