Influencia de la desnutrición en la aparición de complicaciones y mortalidad en pacientes cirróticos

Nutrient Energy Malnutrition (NEM) is a common feature among liver cirrhosis (LC) patients, and might constitute a negative predictor of patient’s survival. A prospective descriptive study was carried out in order to assess the influence of LC patient’s nutritional status on the occurrence of complications and mortality in a tertiary care health institution in Havana City (Cuba). One-hundred twenty-one patients were recruited for the study (Women: 52,9%; Younger than 60 years: 59,0%; Whites: 90,0%). C virus infection, alcoholism, and B virus infection accounted for 71,0% of LC cases. Ninety-two percents of the patients had less than 5 yearse of diagnosis. Subjective Global Assessment (SGA) of nutritional status returned a 45,0% of malnutrition. Malnutrition was associated with disease progression: twenty-one percent of A Child-Pugh Stage patients was malnourished, but this rate increased to become 90,0% among those in C stage. Fat and skeletal muscle compartments were reduced in 36,0 and 37,0% of the patients, respectively. Complications affected 44,6% of the patients. Sixty percent of them were malnourished (p < 0,01). One-year mortality rate was 11,0%. Ninety-two percent of deceased patients were malnourished (p < 0,01). LC malnourished patients have greater risk of complications and death as compared to well-nourished ones. (Nutr Hosp. 2008;23:68-74)

[1]  F. Durand,et al.  [Nutritional assessment in cirrhosis]. , 2008, Gastroenterologie clinique et biologique.

[2]  M. Kondo,et al.  Comparison of three methods of nutritional assessment in liver cirrhosis: subjective global assessment, traditional nutritional parameters, and body composition analysis , 2006, Journal of Gastroenterology.

[3]  J. B. Penié State of malnutrition in Cuban hospitals , 2005 .

[4]  M. Kondo,et al.  Effect of liver cirrhosis on body composition: Evidence of significant depletion even in mild disease , 2005, Journal of gastroenterology and hepatology.

[5]  A. Madden,et al.  The assessment of body composition in patients with cirrhosis , 1996, European Journal of Nuclear Medicine.

[6]  F. Durand,et al.  Évaluation de l’état nutritionnel au cours de la cirrhose : méthodes, limites et implications , 2004 .

[7]  R. C. Burini,et al.  Sensibilidade de indicadores da desnutrição protéico-energética em cirróticos com vários graus de disfunção hepatocelular , 2004 .

[8]  A. Sobhonslidsuk,et al.  Nutritional assessment in various stages of liver cirrhosis. , 2001, Nutrition.

[9]  L. Caregaro,et al.  Nutrition and survival in patients with liver cirrhosis. , 2001, Nutrition.

[10]  F. Santolaria,et al.  Nutritional assessment in alcoholic patients. Its relationship with alcoholic intake, feeding habits, organic complications and social problems. , 2000, Drug and alcohol dependence.

[11]  R. C. Burini,et al.  Implicações do alcoolismo e da doença hepática crônica sobre o metabolismo de micronutrientes , 2000 .

[12]  R. C. Burini,et al.  Conseqüências nutricionais das alterações metabólicas dos macronutrientes na doença hepática crônica , 2000 .

[13]  R. Burini,et al.  [Nutritional consequences of metabolic impairment of macronutrients in chronic liver disease]. , 2000, Arquivos de gastroenterologia.

[14]  E. Bugianesi,et al.  Protein-calorie malnutrition and the etiology of cirrhosis. , 1997, The American journal of gastroenterology.

[15]  J. Saltzman,et al.  Nutrition status predicts survival in cirrhosis. , 2009, Nutrition reviews.

[16]  C. Loguercio,et al.  Nutritional status and survival of patients with liver cirrhosis: anthropometric evaluation. , 1996, Minerva gastroenterologica e dietologica.

[17]  M. Merli,et al.  Does malnutrition affect survival in cirrhosis? , 1996 .

[18]  M. Merli,et al.  Does malnutrition affect survival in cirrhosis? PINC (Policentrica Italiana Nutrizione Cirrosi). , 1996, Hepatology.

[19]  D. Waitzberg,et al.  Insuficiencia hepatica aguda e cronica , 1995 .

[20]  R. Wiesner,et al.  Assessment of nutritional status of patients with end-stage liver disease undergoing liver transplantation. , 1989, Mayo Clinic proceedings.

[21]  M. Merli,et al.  Optimal nutritional indexes in chronic liver disease. , 1987, JPEN. Journal of parenteral and enteral nutrition.

[22]  B. Sepúlveda,et al.  Malnutrition and liver disease in Mexico. , 1957, Gastroenterology.