Nutritional screening and assessment tools for patients with cirrhosis based on the Global Leadership Initiative on Malnutrition criteria.
diagnostic screening program
liver cirrhosis
malnutrition
risk assessment
Journal
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
ISSN: 1365-277X
Titre abrégé: J Hum Nutr Diet
Pays: England
ID NLM: 8904840
Informations de publication
Date de publication:
06 Nov 2023
06 Nov 2023
Historique:
received:
04
08
2023
accepted:
03
11
2023
pubmed:
7
11
2023
medline:
7
11
2023
entrez:
6
11
2023
Statut:
aheadofprint
Résumé
Malnutrition is highly prevalent and associated with complications and mortality in patients with cirrhosis. This was a prospective observational study. Patients with cirrhosis were screened using the Nutritional Risk Screening 2002, the Royal Free Hospital-Nutritional Prioritizing Tool and the Skeletal Muscle Index. Then, the sensitivity, specificity, positive and negative predictive values, and consistency with the Global Leadership Initiative on Malnutrition criteria results were calculated. We also analysed the association between nutritional status and short-term prognosis. We enrolled 125 patients with cirrhosis, of whom 59.20% and 60.00% were malnourished based on the Global Leadership Initiative on Malnutrition criteria and Skeletal Muscle Index. Some 53.60% and 65.60%, respectively, were classified medium-to-high nutritional risk by Nutritional Risk Screening 2002 and the Royal Free Hospital-Nutritional Prioritizing Tool. The Royal Free Hospital-Nutritional Prioritizing Tool had the best predictive value, and it was more sensitive and had a better negative predictive value than the Nutritional Risk Screening 2002 Tool. The Skeletal Muscle Index also had good sensitivity and predictive value. The Royal Free Hospital-Nutritional Prioritizing Tool, Skeletal Muscle Index and Global Leadership Initiative on Malnutrition criteria showed high concordance. The 3- and 6-month mortality rates were significantly higher for patients with moderate-to-high nutritional risk or malnutrition, regardless of the tool. When assessing cirrhosis with the Global Leadership Initiative on Malnutrition criteria, the Royal Free Hospital-Nutritional Prioritizing Tool is best for nutritional screening and the Skeletal Muscle Index is also a good nutritional assessment tool.
Sections du résumé
BACKGROUND
BACKGROUND
Malnutrition is highly prevalent and associated with complications and mortality in patients with cirrhosis.
METHODS
METHODS
This was a prospective observational study. Patients with cirrhosis were screened using the Nutritional Risk Screening 2002, the Royal Free Hospital-Nutritional Prioritizing Tool and the Skeletal Muscle Index. Then, the sensitivity, specificity, positive and negative predictive values, and consistency with the Global Leadership Initiative on Malnutrition criteria results were calculated. We also analysed the association between nutritional status and short-term prognosis.
RESULTS
RESULTS
We enrolled 125 patients with cirrhosis, of whom 59.20% and 60.00% were malnourished based on the Global Leadership Initiative on Malnutrition criteria and Skeletal Muscle Index. Some 53.60% and 65.60%, respectively, were classified medium-to-high nutritional risk by Nutritional Risk Screening 2002 and the Royal Free Hospital-Nutritional Prioritizing Tool. The Royal Free Hospital-Nutritional Prioritizing Tool had the best predictive value, and it was more sensitive and had a better negative predictive value than the Nutritional Risk Screening 2002 Tool. The Skeletal Muscle Index also had good sensitivity and predictive value. The Royal Free Hospital-Nutritional Prioritizing Tool, Skeletal Muscle Index and Global Leadership Initiative on Malnutrition criteria showed high concordance. The 3- and 6-month mortality rates were significantly higher for patients with moderate-to-high nutritional risk or malnutrition, regardless of the tool.
CONCLUSIONS
CONCLUSIONS
When assessing cirrhosis with the Global Leadership Initiative on Malnutrition criteria, the Royal Free Hospital-Nutritional Prioritizing Tool is best for nutritional screening and the Skeletal Muscle Index is also a good nutritional assessment tool.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Chengdu Health Commission Research Project
ID : 2021414
Organisme : Chengdu Science and Technology Bureau
ID : 2021-YF05-00585-SN
Organisme : Foundation of Science and Technology Department of Sichuan Province
ID : 2022YFS0340
Organisme : Foundation of Medical Association of Sichuan Province
ID : S22085
Informations de copyright
© 2023 British Dietetic Association.
Références
Maharshi S, Sharma BC, Srivastava S. Malnutrition in cirrhosis increases morbidity and mortality. J Gastroenterol Hepatol. 2015;30(10):1507-1513.
Shergill R, Syed W, Rizvi SA, Singh I. Nutritional support in chronic liver disease and cirrhotics. World J Hepatol. 2018;10(10):685-694.
Ribeiro HS, Maurício SF, Antônio da Silva T, de Vasconcelos Generoso S, Lima AS, Toulson Davisson Correia MI. Combined nutritional assessment methods to predict clinical outcomes in patients on the waiting list for liver transplantation. Nutrition. 2018;47:21-26.
Traub J, Reiss L, Aliwa B, Stadlbauer V. Malnutrition in patients with liver cirrhosis. Nutrients. 2021;13(2):540.
Kondrup J. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-336.
Plauth M, Bernal W, Dasarathy S, Merli M, Plank LD, Schütz T, et al. ESPEN guideline on clinical nutrition in liver disease. Clin Nutr. 2019;38(2):485-521.
Wu Y, Zhu Y, Feng Y, Wang R, Yao N, Zhang M, et al. Royal Free Hospital-Nutritional Prioritizing Tool improves the prediction of malnutrition risk outcomes in liver cirrhosis patients compared with Nutritional Risk Screening 2002. Br J Nutr. 2020;124(12):1293-1302.
Amodio P, Bemeur C, Butterworth R, Cordoba J, Kato A, Montagnese S, et al. The nutritional management of hepatic encephalopathy in patients with cirrhosis: International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus. Hepatology. 2013;58(1):325-336.
Borhofen SM, Gerner C, Lehmann J, Fimmers R, Görtzen J, Hey B, et al. The Royal Free Hospital-Nutritional Prioritizing Tool is an independent predictor of deterioration of liver function and survival in cirrhosis. Dig Dis Sci. 2016;61(6):1735-1743.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
Han JW, Kim DI, Nam HC, Chang UI, Yang JM, Song DS. Association between serum tumor necrosis factor-α and sarcopenia in liver cirrhosis. Clin Mol Hepatol. 2022;28(2):219-231.
European Association for the Study of the Liver. Electronic address eee, European Association for the Study of the L. EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J Hepatol. 2019;70(1):172-193.
Xu Z, Yang D, Luo J, Xu H, Jia J, Yang Z. Diagnosis of sarcopenia using the L3 skeletal muscle index estimated from the L1 skeletal muscle index on MR images in patients with cirrhosis. J Magn Reson Imaging. 2023;58:1569-1578.
Lai JC, Tandon P, Bernal W, Tapper EB, Ekong U, Dasarathy S, et al. Malnutrition, frailty, and sarcopenia in patients with cirrhosis: 2021 practice guidance by the American Association for the study of liver diseases. Hepatology. 2021;74(3):1611-1644.
Topan MM, Sporea I, Dănilă M, Popescu A, Ghiuchici AM, Lupușoru R, et al. Comparison of different nutritional assessment tools in detecting malnutrition and sarcopenia among cirrhotic patients. Diagnostics. 2022;12(4):893.
Kang SH, Jeong WK, Baik SK, Cha SH, Kim MY. Impact of sarcopenia on prognostic value of cirrhosis: going beyond the hepatic venous pressure gradient and MELD score. J Cachexia Sarcopenia Muscle. 2018;9(5):860-870.
Mauro E, Crespo G, Martinez-Garmendia A, Gutierrez-Acevedo MN, Diaz JM, Saidman J, et al. Cystatin C and sarcopenia predict acute on chronic liver failure development and mortality in patients on the liver transplant waiting list. Transplantation. 2020;104(7):e188-e198.
Zeng X, Shi ZW, Yu JJ, Wang LF, Luo YY, Jin SM, et al. Sarcopenia as a prognostic predictor of liver cirrhosis: a multicentre study in China. J Cachexia Sarcopenia Muscle. 2021;12(6):1948-1958.
de van der Schueren MAE, Keller H, Cederholm T, Barazzoni R, Compher C, Correia MITD, et al. Global Leadership Initiative on Malnutrition (GLIM): Guidance on validation of the operational criteria for the diagnosis of protein-energy malnutrition in adults. Clin Nutr. 2020;39(9):2872-2880.
Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition-a consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9.
Jensen GL, Cederholm T, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition: a consensus report from the Global Clinical Nutrition Community. J Parenter Enteral Nutr. 2019;43(1):32-40.
Wang X, Feng H, Hui Y, Yu Z, Zhao T, Mao L, et al. Neutrophil-to-lymphocyte ratio is associated with malnutrition risk estimated by the Royal Free Hospital-Nutritional Prioritizing Tool in hospitalized cirrhosis. J Parenter Enteral Nutr. 2022;46(1):123-129.
Placha D, Jampilek J. Chronic inflammatory diseases, anti-inflammatory agents and their delivery nanosystems. Pharmaceutics. 2021;13(1):64.
Topan MM, Sporea I, Dănilă M, Popescu A, Ghiuchici AM, Lupuşoru R, et al. Impact of sarcopenia on survival and clinical outcomes in patients with liver cirrhosis. Front Nutr. 2021;8:766451.
Pourhassan M, Cederholm T, Trampisch U, Volkert D, Wirth R. Inflammation as a diagnostic criterion in the GLIM definition of malnutrition-what CRP-threshold relates to reduced food intake in older patients with acute disease? Eur J Clin Nutr. 2022;76(3):397-400.
Koulentaki M, Drygiannakis I, Mantaka A, Moschapidakis E, Chalkiadaki A, Augoustaki A, et al. Nutritional assessment of greek liver cirrhosis patients: mini nutritional assessment predicts mortality. Healthcare. 2022;10(5):859.
Javaid N, Khan Z, Ali MA, Tahir SK. Evaluating the impact of early nutritional assessment and intervention in hospitalized liver cirrhosis patients. Arq Gastroenterol. 2022;59(1):22-28.
Boulhosa RSSB, Lourenço RP, Côrtes DM, Oliveira LPM, Lyra AC, de Jesus RP. Comparison between criteria for diagnosing malnutrition in patients with advanced chronic liver disease: GLIM group proposal versus different nutritional screening tools. J Hum Nutr Diet. 2020;33(6):862-868.
Matsumoto Y, Iwai K, Namikawa N, Matsuda S, Wakano C, Heya H, et al. The relationship between existing nutritional indicators and Global Leadership Initiative on Malnutrition (GLIM) criteria: a one-institution cross-sectional analysis. Clin Nutr. 2020;39(10):3099-3104.
Allard JP, Keller H, Gramlich L, Jeejeebhoy KN, Laporte M, Duerksen DR. GLIM criteria has fair sensitivity and specificity for diagnosing malnutrition when using SGA as comparator. Clin Nutr. 2020;39(9):2771-2777.
Rattanachaiwong S, Zribi B, Kagan I, Theilla M, Heching M, Singer P. Comparison of nutritional screening and diagnostic tools in diagnosis of severe malnutrition in critically ill patients. Clin Nutr. 2020;39(11):3419-3425.
Ciocirlan M, Cazan AR, Barbu M, Mănuc M, Diculescu M, Ciocîrlan M. Subjective global assessment and handgrip strength as predictive factors in patients with liver cirrhosis. Gastroenterol Res Pract. 2017;2017:8348390.
Bunchorntavakul C, Reddy KR. Review article: malnutrition/sarcopenia and frailty in patients with cirrhosis. Aliment Pharmacol Ther. 2020;51(1):64-77.
Patel VC, Lee S, McPhail MJW, Da Silva K, Guilly S, Zamalloa A, et al. Rifaximin-α reduces gut-derived inflammation and mucin degradation in cirrhosis and encephalopathy: RIFSYS randomised controlled trial. J Hepatol. 2022;76(2):332-342.
Conte M, Vasuri F, Trisolino G, Bellavista E, Santoro A, Degiovanni A, et al. Increased Plin2 expression in human skeletal muscle is associated with sarcopenia and muscle weakness. PLoS One. 2013;8(8):e73709.
Li H, Malhotra S, Kumar A. Nuclear factor-kappa B signaling in skeletal muscle atrophy. J Mol Med. 2008;86(10):1113-1126.
Figueiredo FAF, Perez RM, Freitas MM, Kondo M. Comparison of three methods of nutritional assessment in liver cirrhosis: subjective global assessment, traditional nutritional parameters, and body composition analysis. J Gastroenterol. 2006;41(5):476-482.
Yang W, Guo G, Cui B, Li Y, Sun M, Li C, et al. Malnutrition according to the Global Leadership Initiative on Malnutrition criteria is associated with in-hospital mortality and prolonged length of stay in patients with cirrhosis. Nutrition. 2023;105:111860.
van Bokhorst-de van der Schueren MAE, Guaitoli PR, Jansma EP, de Vet HCW. Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr. 2014;33(1):39-58.