Nutritional Assessment of Patients with Liver Cirrhosis by Nutrition Screening Tool and Anthropometry at a Tertiary Care Center

  • Tshering W Sherpa
  • Rahul Pathak
  • Prem K Khadga
  • Sashi Sharma
  • Rabin Hamal
  • Anurag Jha

Abstract

Introduction
Malnutrition is one of the most common complications of liver cirrhosis. Yet, little attention is paid in evaluating
nutrition in this group of patients. This study aims to assess malnutrition among cirrhotic patients using a nutrition
screening tool and anthropometry.
Methods
This was a prospective, observational study of admitted patients with liver cirrhosis. In the study duration of 3
months, 50 patients met the inclusion criteria and were included. Nutritional assessment was performed using
the Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT), BMI and standard anthropometry including TSF,
MUAC and MAMC.
Results
The mean age was 51.56 ± 11.50 with a Male to Female ratio of 3:2. Chronic alcohol consumption (72%) was
the most common etiology while management of tense ascites (40%) was the most common reason for hospital
admission. 58% had Child Pugh Class C cirrhosis while the remaining 42% were Class B. The average MELD Na
score was 19.64 ± 6. Significant differences in anthropometric measurements including BMI, MUAC, TSF and
MAMC were found between Child B and C cirrhosis. Similarly, those patients who had low, moderate and high
risk of malnutrition by the RFH-NPT had significant differences in anthropometric measurements between them.
Conclusion
A significant number of patients had moderate to severe risk of malnutrition that correlated well with
anthropometric measurements. The degree of malnutrition is parallel with the severity of liver disease among
these patients. Both the RFH-NPT and anthropometry are relatively easy to perform and effective. Hence, they
can be used as a practical means for identifying malnutrition among cirrhotic patients in routine clinical practice.
Keywords
Anthropometry, liver cirrhosis, malnutrition

Published
2019-08-26