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Nutritional status and prognosis in cirrhotic patients

Gunsar, F; Raimondo, ML; Jones, S; Terreni, N; Wong, C; Patch, D; ... Burroughs, AK; + view all (2006) Nutritional status and prognosis in cirrhotic patients. ALIMENT PHARM THER , 24 (4) 563 - 572. 10.1111/j.1365-2036.2006.03003.x.

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Abstract

Background and Aim The potential prognostic value for survival of nutritional status in cirrhotics after adjusting Child-Pugh classification and Model for End-Stage Liver Disease has not been evaluated.Methods We used Kaplan-Meier and Cox proportional hazards regression models to identify factors associated with mortality in a cohort of 222 cirrhotics [M/F:145/77 median age 52 (18-68) years] with prospectively collected nutritional parameters as well as modified subjective global nutritional assessment, Royal Free Hospital-Subjective Global Assessment index. Follow-up was censored at the time of transplantation. Other variables were ones in Child-Pugh and Model for End-Stage Liver Disease scores, age, aetiology of cirrhosis and renal function,Results Pretransplant mortality (Kaplan-Meier) was 21% by 2 years (135 patients were transplanted). Among the nutritional parameters, only Royal Free Hospital-Subjective Global Assessment remained significantly associated with mortality in multivariable models (P = 0.0006). The final model included the following variables: urea (P = 0.0001), Royal Free Hospital-Subjective Global Assessment (P = 0.003), age (P = 0.0001), Child-Pugh grade (P = 0.009) and prothrombin time (P = 0.003). The results were similar when the Child-Pugh grade was replaced by the Model for End-Stage Liver Disease score in the model, and whether a competing risks model was used.Conclusions Nutritional indices add significantly to both Child-Pugh grade and Model for End-Stage Liver Disease scores when assessing the patient prognosis.

Type:Article
Title:Nutritional status and prognosis in cirrhotic patients
DOI:10.1111/j.1365-2036.2006.03003.x
Keywords:SUBJECTIVE GLOBAL ASSESSMENT, STAGE LIVER-DISEASE, TRANSPLANTATION, SURVIVAL, MELD, MODEL, INDICATORS, PARAMETERS, OUTCOMES, NORMS
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Infection and Population Health

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