Association between Nutrition Assessment Tools and Long-Term Survival in Cirrhosis Patients Undergoing Liver Transplant Assessment - Abstract
Background: This study aimed to explore longitudinal relationships between bedside nutrition assessment tools (NAT): hand grip strength (HGS), mid upper arm circumference (MAC), and subjective global assessment (SGA), and clinical outcomes including: liver related hospitalizations, and liver transplant-free survival (LTFS) in patients undergoing liver transplantation assessment.
Methods: Cirrhosis patients, referred to a cirrhosis focused malnutrition clinic, (N=41) completed NAT during the baseline visit and received one follow-up visit with NAT reassessment and were then followed up 24-months post assessment (median 23.0 months (IQR: 10.5 -29.1)). Log rank Kaplan-Meier and Cox proportional-hazard regression models were used to assess associations between demographic, clinical characteristics and NAT with outcomes.
Results: Neither baseline NAT assessment or improvements affected the risk of hospitalizations in our cohort. In univariate analyses, improvement of SGA status (Hazard ratio [HR]: 0.28, 95% confidence interval [CI] 0.09-0.88, p=0.03) HGS (HR: 0.91, 95%CI 0.83-1.00, p=0.05) and MAC (HR 0.85, 95% 0.72.1.00, p=0.05) were associated with LTFS.
However, NAT did not independently predict LTFS in adjusted multivariate analyses.
Conclusions: Prospective larger cohorts are needed to further evaluate the impact of temporal improvement of NAT on LTFS and hospitalizations.]