Sasidharan Madhu, Nistala Srinivas, Narendhran R T, Murugesh M, Bhatia Shobna J, Rathi Pravin M
Department of Gastroenterology and Hepatology, TNMC-BYL Nair Hospital, Mumbai, India.
Trop Gastroenterol. 2012 Oct-Dec;33(4):257-64.
Malnutrition is commonly associated with chronic liver disease. The presence of protein-calorie malnutrition has been shown to be associated with increased short- and long-term mortality in patients with acute and chronic liver disease. We undertook this study to assess the prognostic value of nutritional status in predicting survival in cirrhotic patients. The aim of our study was to determine whether assessment of nutritional status using the RFH-SGA score adds significantly to CP (Child-Pugh) and MELD scores in predicting patient prognosis and survival in cirrhotic patients.
Diagnosed cases of cirrhosis were enrolled and their nutritional assessment was done using the RFH-SGA score. All patients were followed up for a period of 6 months. The mortality rates in the various groups were compared with respect to their nutritional status. Multivariate analysis was used to determine the factors associated with mortality.
A total of 73 cirrhotic patients were taken up for this study. Of these, 23 patients (31.5%) were well nourished, 21 (28.8%) had mild to moderate malnourishment and 29 (39.7%) were severely malnourished. Multivariate analyses of various parameters identified poor nutritional status, increased CP grade, increased creatinine, lower sodium levels and longer prothrombin time as being independently associated with poorer survival.
RFH-SGA is a simple and inexpensive tool for assessing the nutritional status in cirrhotic patients and can reliably predict their disease prognosis and survival.
营养不良通常与慢性肝病相关。蛋白质 - 热量营养不良的存在已被证明与急慢性肝病患者的短期和长期死亡率增加有关。我们进行这项研究以评估营养状况在预测肝硬化患者生存中的预后价值。我们研究的目的是确定使用RFH - SGA评分评估营养状况在预测肝硬化患者的预后和生存方面是否能显著补充Child - Pugh（CP）评分和终末期肝病模型（MELD）评分。
纳入确诊的肝硬化病例，并使用RFH - SGA评分进行营养评估。所有患者随访6个月。比较不同组患者的死亡率与营养状况。采用多因素分析确定与死亡率相关的因素。
本研究共纳入73例肝硬化患者。其中，23例（31.5%）营养良好，21例（28.8%）有轻度至中度营养不良，29例（39.7%）严重营养不良。对各种参数的多因素分析确定，营养状况差、CP分级增加、肌酐升高、血钠水平降低和凝血酶原时间延长与较差的生存率独立相关。
RFH - SGA是评估肝硬化患者营养状况的一种简单且廉价的工具，能够可靠地预测其疾病预后和生存情况。
