Objective: To investigate the prevalence of nutritional risk and malnutrition among in-patients with liver diseases in Beijing, China, and to evaluate the relationship between nutritional risk and prognosis.
Methods: A total of 331 in-patients with liver diseases under care at the Artificial Liver Center of Beijing Youan Hospital were consecutively enrolled for study between April 2012 and December 2012. Nutritional status was determined by calculating each patient's ratio of real weight to clinically ideal weight, the triceps skin fold (TSF), and the mid-upper arm muscle circumference (MAMC). Nutritional risk was estimated using the Nutritional Risk Screening questionnaire 2002 (NRS-2002). In addition, each patient's Child-Pugh stage, body mass index (BMI), power of gripping, serum albumin and pre-albumin levels, lymphocyte count, hospital length of stay, complications, alcoholism history, and outcome after discharge were recorded for analysis.
Results: One-hundred-and-thirteen of the patients (34.1%) were defined as at nutritional risk upon hospital admission. The ratio of nutritional risk was lowest in patients with chronic hepatitis (17.0%) and highest in patients with acute on chronic liver failure (56.5%). The ratios of malnutrition evaluated by TSF and MAMC were 36.9% and 38.7%, respectively. Among the patients with liver cirrhosis or hepatocellular carcinoma, the ratio of Child-Pugh stage C was higher for individuals defined as at nutritional risk than for those without. When TSF-based ratio of malnutrition was higher for individuals with a history of alcoholism than for those without. BMI, power of gripping, serum albumin level, serum pre-albumin level, and lymphocyte count were all lower for individuals defined as at nutritional risk than for those without. Hospital stay, ratio of complication onset, and ratio of death were all higher for individuals defined as at nutritional risk than for those without.
Conclusion: TSF and MAMC can be used to evaluate the nutritional status of in-patients with liver diseases. Patients with nutritional risk (as determined by the NRS-2002) have poorer prognosis and may benefit from nutritional intervention.