Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin300052, People's Republic of China.
Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin300052, People's Republic of China.
Br J Nutr. 2023 Sep 14;130(5):860-867. doi: 10.1017/S0007114522003841. Epub 2022 Dec 2.
Patients with cirrhosis experience worse health-related quality of life (HRQoL), and attempts are warranted further exploration of modifiable factors to improve HRQoL. Data on the impact of malnutrition risk on HRQoL among cirrhosis are limited; thus, we aimed to strengthen understanding by clarifying the relationship between nutritional status and low HRQoL in patients with decompensated cirrhosis. Consecutive inpatients with cirrhosis attending our department within a tertiary hospital were studied. Generic health profiles and malnutrition risk were evaluated by the EuroQol-5D (EQ-5D) and Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) score, respectively. Multiple linear regression analysis was used to determine association of malnutrition risk with low HRQoL. In this cohort of 364 patients with median age of 64 years and 49·5 % male, 55·5 % of the study population reported impairment pertinent to HRQoL in at least one dimension in terms of the EQ-5D. Moreover, malnutrition risk (RFH-NPT score: coefficient = -0·114, = 0·038) was proved to be independently associated with poor HRQoL in multiple analysis, after adjustment for significant variables like age, BMI and markers of decompensation. Notably, we found that health dimensions representing physical function (i.e. mobility, self-care and usual activities) are substantially affected, while malnourished patients reported less frequencies of complaints in other domain such as anxiety/depression. In conclusion, the risk of malnutrition assessed by the RFH-NPT score is independently associated with low HRQoL. It is operational to improve HRQoL by identifying patients at high malnutrition risk and providing timely nutrition treatment.
患者患有肝硬化，其健康相关生活质量（HRQoL）更差，因此有必要进一步探索可改变的因素来提高 HRQoL。关于营养不良风险对肝硬化患者 HRQoL 影响的数据有限；因此，我们旨在通过阐明营养不良状态与失代偿期肝硬化患者低 HRQoL 之间的关系来加强对此的理解。在一家三级医院的我们科室，连续收治了患有肝硬化的住院患者。通过欧洲五维健康量表（EQ-5D）和皇家自由医院营养优先工具评分（RFH-NPT）分别评估通用健康状况和营养不良风险。使用多元线性回归分析来确定营养不良风险与低 HRQoL 之间的关联。在该队列中，364 名患者的中位年龄为 64 岁，男性占 49.5%，55.5%的研究人群报告在 EQ-5D 的至少一个维度上存在与 HRQoL 相关的损害。此外，经过对年龄、BMI 和失代偿标志物等重要变量的调整，多元分析证实营养不良风险（RFH-NPT 评分：系数=-0.114，p=0.038）与较差的 HRQoL 独立相关。值得注意的是，我们发现代表身体功能的健康维度（即移动性、自我护理和日常活动）受到了实质性影响，而营养不良的患者在其他方面（如焦虑/抑郁）的抱怨频率较低。总之，RFH-NPT 评分评估的营养不良风险与低 HRQoL 独立相关。通过识别高营养不良风险的患者并提供及时的营养治疗，可以提高 HRQoL。
