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 23 November 2017

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News

Evaluation of nutritional practice in hospitalized cirrhotic patients

Hospitalized cirrhotic patients have a high prevalence rate of malnutrition, finds a research team in the June issue of Nutrition.

News image

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In this study, researchers from France evaluated the impact of malnutrition and nutrition practice in 396 hospitalized cirrhotic patients.

The research team measured triceps skinfold thickness and mid-arm muscle circumference were measured at admission.

They also evaluated spontaneous dietary intake at admission and during hospital stay.

The researchers found that ascites was associated with impairment of nutrition status. They determined that of non-ascitic patients 49% had mid-arm muscle circumferences and 30% triceps skinfold thickness below the fifth percentile of a reference population.

Mortality rate was 15% during hospital stay.
Nutrition

This was also the case for 49% and 41% of patients with mild ascites, and 66% and 48% of patients with tense ascites.

The team found that decrease in dietary intake paralleled worsening of liver failure. In Child A patients 48% had caloric intakes below 30 kcal/kg of body weight and 34% protein intakes below 1 g/kg of body weight. This was the case in 52% and 36% of Child B patients, and 80% and 63% of Child C patients.

The team determined that mortality rate was 15% during hospital stay. They found that Child-Pugh score, age, severe septic complications, and decrease in caloric intake during hospital stay were independently associated with mortality.

In addition, 24 patients required enteral feeding due to low caloric intake (<25 kcal/kg) despite oral supplements. This was initiated before admission in 4 patients and after 12.4 days of hospitalization in 20 patients.

The team found that the patients receiving enteral feeding were older, and had a higher Child-Pugh score. They also had a higher mortality rate than other patients.

Dr Bernard Campillo's team concluded, "Hospitalized cirrhotic patients have a high prevalence rate of malnutrition, and most do not satisfy their nutritional requirements".

"Decrease in caloric intake is an independent risk factor of short-term mortality".

"Enteral nutrition after failure of oral supplementation has no clinical benefit".

"Tube feeding may be indicated earlier in the course of the disease".

Nutrition 2003; 19(6): 515-21
30 May 2003

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