Nutritional assessments for ordinary medical care in patients with chronic liver disease

Abstract

PNI and CONUT are potential tools for nutritional assessment in patients with chronic liver disease, especially for ordinary medical care, because of their simplicity.

Validation of a Screening Tool to Identify Undernutrition in Ambulatory Patients With Liver Cirrhosis

“…As healthcare demands and costs rise, methods to simply, accurately, and consistently detect changes in nutrition status are needed to identify patients who are in need of more intense nutrition interventions without increasing the burden on healthcare providers 2 , 4 , 6 , 12 , 14 , 15 . Indeed, Juakiem et al 2 asserted that a full nutrition assessment on all patients with liver disease is not a realistic expectation, further demonstrating the need for an accepted screening method for this population.…”

“…Anthropometric measures such as midarm circumference, triceps skinfolds, and midarm muscle circumference require staff training and properly calibrated tools to administer, and so these measures may not be readily available during the nutrition screening process 8 , 11 , 15 . Furthermore, the link between these measures and malnutrition has been debated in the literature; thus, the accuracy of any screening tool that uses these anthropometric measures may be in question 8 , 11 , 14 . Additionally, the presence of fluid accumulation was included as a construct in the undernutrition tool.…”

Nutrition in the Management of Cirrhosis and its Neurological Complications

“…126 These are simple assessment constructs of only two or three biochemical examinations of (blood albumin, total lymphocyte count, and total cholesterol) that were shown to be associated with both the severity of chronic liver disease and anthropometric values leading the authors to propose that they represent simple effective tools for nutritional assessment in patients with chronic liver disease. However, the use of albumin, a visceral protein synthesized by the liver, in these equations is questionable since visceral proteins appear to correlate better with the severity of underlying liver disease rather than with malnutrition status.…”

Nutrition principles and recommendations in different types of hepatic encephalopathy

“…Clinical examination is an obvious basis. The objective assessment methods applicable to nutritional status evaluation include bioelectric impedance analysis (BIA), dual X-ray absorptiometry (DXA), hand-grip dynamometry, computed tomography (CT) or nuclear magnetic resonance (NMR) imaging to assess muscle mass, body mass index (BMI), Subjective Global Assessment (SGA), the CONUT scale [6] (Table 2), the Royal Free Hospital Nutritional Prioritising Tool and many others.…”