Clinical and laboratory characteristics of cirrhotic patients associated with moderate and severe malnutrition
Barcelos,Samantha Thifani Alrutz
Alencar,Maria Luiza Aires
Schiavon,Leonardo de Lucca
Context and objective: Protein-energy malnutrition is described Context and objective: Protein-energy malnutrition is described in 25-100% of patients with cirrhosis. The aim of this study was to evaluate the nutritional status of cirrhotic patients, to identify clinical and laboratory variables associated with moderate to severe malnutrition and to correlate them with cirrhosis prognostic factors (Child-Pugh Classification). Design and setting: This cross-sectional study evaluated cirrhotic individuals admitted to University Hospital from December 2011 to August 2012. Methods: Nutritional status was evaluated by Subjective Global Assessment (SGA), total lymphocyte count and serum albumin. Bivariate analysis was used to identify variables associated with Child C and with moderate to severe malnutrition in different nutritional classifications. Results: Sixty-seven patients were included (mean age 54.4 ± 11.7 years; 74.6% men). The mean MELD score was 14.5 ± 6.5, and almost 30% of the individuals were classified as Child C. With respect to nutritional status, 20.9% showed severe malnutrition by SGA, 14.9% malnutrition by total lymphocyte count, and 40.3% by albumin levels. In all methods employed, moderate to severe malnutrition was correlated with Child classification grade C. The rate of moderate to severe malnutrition by SGA was lower than that evidenced by laboratory methods. Nevertheless, SGA indicated a greater proportion of Child C patients with moderate to severe malnutrition. Conclusion: Due to the high prevalence of malnutrition and its correlation to the severity of cirrhosis, the nutritional evaluation ofcirrhotic patients is an essential step that can be performed through simple methods in routine hospital care.