Hepato-gastroenterology Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), 1200 Brussels, Belgium.
Université catholique de Louvain, CHU UCL Namur, Department of Gastroenterology and Hepatology, 5530 Yvoir, Belgium.
Acta Gastroenterol Belg. 2022 Apr-Jun;85(2):311-319. doi: 10.51821/85.2.9016.
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.
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.
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).
Malnutrition is highly prevalent in hospitalized cirrhotic patients. Malnutrition, low prognostic nutritional index and low Braden scale are associated with poor outcomes in cirrhosis.
营养不良对住院肝硬化患者预后的影响尚未完全阐明。本研究旨在确定营养不良的发生率、功能评分及其对住院肝硬化患者预后的影响。
本回顾性研究纳入了 2014 年 4 月至 2014 年 9 月期间在布鲁塞尔圣吕克大学医院消化内科住院的所有肝硬化患者。根据最低临床综合诊断标准评估营养状况。在为期一年的随访中分析肝硬化相关并发症或死亡的发生情况。
95 例肝硬化患者进行了营养状况和结局评估。营养不良影响了 45.3%的患者，且随着肝硬化严重程度的增加而更为常见：Child-Pugh A 患者为 29%，Child-Pugh B 患者为 48.8%，Child-Pugh C 患者为 72.2%。58.9%的患者发生了肝硬化相关并发症（营养不良组为 60.7%，vs. 39.3%，p<0.001，OR 5.06，95%CI 1.90-14.58），33.7%的患者死亡（68.75% vs. 31.25%，p=0.002，OR 4.33，95%CI 1.62-12.28）。在校正年龄、钠、MELD、Charlson 指数、肝细胞癌、血小板、糖尿病、预后营养指数和 Braden 量表后，营养不良与更高的死亡率和发病率显著相关，OR 分别为 3.56（95%CI 1.55-8.16）和 2.09（95%CI 1.16-3.77）。Braden 量表与更高的死亡率显著相关（p=0.027，OR 1.25，95%CI 1.03-1.52），而预后营养指数与更高的发病率相关（p=0.001，OR 0.94，95%CI 0.90-0.98）。
住院肝硬化患者中营养不良的发生率很高。营养不良、低预后营养指数和低 Braden 量表与肝硬化患者不良预后相关。
