eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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3/2023
vol. 18
 
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abstract:
Original paper

Evaluation of nutritional status in patients with liver cirrhosis. Validity and prognostic value of the Patient-Generated Subjective Global Assessment

Nataliia Pentiuk
1
,
Vitalii Motsiuk
1

  1. Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Gastroenterology Rev 2023; 18 (3): 327–333
Online publish date: 2022/10/01
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Introduction
Malnutrition is a common condition in liver cirrhosis (LC), which is associated with poor survival. Despite the wide range of tools, there is no agreement on a standard nutritional assessment method applicable to LC. Aim: To determine the validity and prognostic value of the Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional assessment tool in LC patients.

Material and methods
In 2019–2021, 161 patients with LC (aged 55.2 ±11.6 years) were involved, of whom 23, 57, and 81 patients were classified as Class A, B, and C Child-Turcotte-Pugh (CTP), accordingly. Fifty patients died during follow-up (489 (293–639) days). The PG-SGA, Controlling Nutritional Status (CONUT), handgrip strength, and skeletal muscle index (SMI) were used to assess nutritional status.

Results
According to the PG-SGA 29.8% of patients were moderately malnourished and 29.8% were severely malnourished. 50.6% of CTP C patients were severely malnourished. Numerical PG-SGA correlated with CTP, Model for End-Stage Liver Disease, CONUT, SMI, and handgrip strength. Low SMI and handgrip strength were present in 87.5% and 66.7% of severely malnourished patients, respectively. PG-SGA predicted mortality (AUC = 0.775, p < 0.001). Severely malnourished patients had significantly lower survival than moderately malnourished and well-nourished patients in the Kaplan-Meier analysis. Hepatic encephalopathy (HR = 2.29, p = 0.046), hypoalbuminemia (HR = 2.27, p = 0.022), and severe malnutrition according to PG-SGA (HR = 2.39, p = 0.016) were independent predictors of mortality in Cox proportional hazards regression analysis.

Conclusions
The PG-SGA is a reliable nutritional assessment tool and can predict mortality in LC patients.

keywords:

liver cirrhosis, nutritional assessment, Patient-Generated Subjective Global Assessment, malnutrition, skeletal muscle, survival

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