Journal
NUTRITION
Volume 21, Issue 2, Pages 113-117Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.nut.2004.02.002
Keywords
cirrhosis; nutritional assessment; clinical outcome; dynamometry; handgrip strength
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Objective: This study compared three methods of assessing malnutrition in cirrhotics and correlated nutritional status with clinical outcome. Methods: This cross-sectional study evaluated nutritional status by subjective global assessment (SGA), prognostic nutritional index (PNI), and handgrip strength (HG) in outpatients with cirrhosis (n = 50) and two control groups with hypertension (n = 46) and functional gastrointestinal disorders (n = 49). Patients with cirrhosis were followed for I y to verify the incidence of major complications, the need for transplantation, and death. Results: Among patients with cirrhosis, 88% were Child-Pugh A and only 12% were Child-Pugh B. Among these, prevalences of malnutrition were 28% by SGA, 18.7% by PNI, and 63% by HG (P < 0.05). HG, but not SGA or PNI, predicted a poorer clinical outcome in patients with cirrhosis because major complications such as uncontrolled ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome developed in 65.5% of malnourished patients versus 11.8% of well-nourished ones (P < 0.05). No significant differences by any method were seen between the two groups regarding liver transplantation or death. Conclusions: There was a high prevalence of malnutrition in cirrhotic outpatients, especially when assessed by HG, which was superior to SGA and PNI in this study. HG was the only technique that predicted a significant incidence of major complications in I y in undernourished cirrhotic patients. (c) 2005 Elsevier Inc. All rights reserved.
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