Nutritional status and the performance of multiple bedside tools for nutrition assessment among patients waiting for liver transplantation: A Canadian experience

Marr, Kaleb J.; Shaheen, Abdel Aziz M.; Lam, Louisa; Stapleton, Melanie; Burak, Kelly W.; Raman, Maitreyi

doi:10.1016/j.clnesp.2016.10.003

Cited by 28 publications

(27 citation statements)

References 21 publications

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“…Therefore, in our institution, a single dedicated dietitian has been collecting the data of all patients. However, ideally, a tool should be developed that can be easily used even by an untrained person and provide reasonable diagnostic accuracy (2,21,22).…”

Section: Relationships Of the Ac And %Ac Between The Bia-based Data Amentioning

confidence: 99%

The Anthropometric Assessment With the Bioimpedance Method Is Associated With the Prognosis of Cirrhotic Patients

Moriwaki

Enomoto

Saito

et al. 2020

In Vivo

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Background/Aim: The bioimpedance analysis (BIA) can provide anthropometric data on patients. The aim of the study is to evaluate the clinical relevance of these automatically obtained values. Patients and Methods: We studied the arm circumference (AC) and arm muscle circumference (AMC) of 197 histologically proven cirrhotic patients. The BIA-based anthropometric data were compared to the manually measured data. In addition, we evaluated whether or not the BIA-based anthropometric data were associated with the prognosis of the patients. Results: The data of %AC and %AMC obtained using the two methods were well correlated (p<0.001) with relatively inconspicuous differences (approximately 6.0% for %AC and 16.0% for %AMC). The data of %AC and %AMC obtained from the BIA method were significantly associated with the prognosis of the patients. Conclusion: The BIA-based anthropometric data were associated with the direct measurement data and related to the prognosis of cirrhotic patients.

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Section: Relationships Of the Ac And %Ac Between The Bia-based Data Amentioning

confidence: 99%

The Anthropometric Assessment With the Bioimpedance Method Is Associated With the Prognosis of Cirrhotic Patients

Moriwaki

Enomoto

Saito

et al. 2020

In Vivo

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“…Given that patient outcomes may be impacted by numerous factors, we examined the role of nutrition status as well as the presence of sarcopenia. The presence of malnutrition was assessed using the validated subjective global assessment (SGA) tool, and patients were classified as well‐nourished or moderately or severely malnourished by trained registered dietitians specializing in transplantation . The moderately and severely malnourished patients were combined into a single group and identified as malnourished.…”

Section: Methodsmentioning

confidence: 99%

“…The presence of malnutrition was assessed using the validated subjective global assessment (SGA) tool, and patients were classified as well-nourished or moderately or severely malnourished by trained registered dietitians specializing in transplantation. (23)(24)(25) The moderately and severely malnourished patients were combined into a single group and identified as malnourished. SGA has been consistently used at our institution since 1987.…”

Section: Nutrition Statusmentioning

confidence: 99%

Impact of Prior Bariatric Surgery on Perioperative Liver Transplant Outcomes

Idriss

Hasse

et al. 2019

Liver Transpl

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Bariatric surgery (BS) is effective in treating morbid obesity, but the impact of prior BS on candidacy for liver transplantation (LT) is unclear. We examined 78 patients with cirrhosis with prior BS compared with a concurrent cohort of 156 patients matched by age, Model for End‐Stage Liver Disease score, and underlying liver disease. We compared rates of transplant denial after evaluation, delisting on the waiting list, and survival after LT. The median time from BS to LT evaluation was 7 years. Roux‐en‐Y gastric bypass was the most common BS procedure performed (63% of cohort). Nonalcoholic fatty liver disease was the leading etiology for liver cirrhosis (47%). Delisting/death on the waiting list was higher among patients with BS (33.3% versus 10.1%; P = 0.002), and the transplantation rate was lower (48.9% versus 65.2%; P = 0.03). Intention‐to‐treat (ITT) survival from listing to 1 year after LT was lower in the BS cohort versus concurrent cohort (1‐year survival, 84% versus 90%; P = 0.05). On adjusted analysis, a history of BS was associated with an increased risk of death on the waiting list (hazard ratio [HR], 5.7; 95% confidence interval [CI], 2.2‐15.1), but this impact was attenuated (HR, 4.9; 95% CI, 1.8‐13.4) by the presence of malnutrition. When limited to matched controls by sex, mortality attributed to BS was no longer significant for females (P = 0.37) but was significant for males (P = 0.046). Sarcopenia, as captured by skeletal muscle index, was calculated in a subset of patients (n = 49). The total skeletal surface area was lower in the BS group (127 [105‐141] cm2 versus 153 [131‐191] cm2; P = 0.005). Rates of sarcopenia were higher among patients delisted after listing (71.4% versus 16.7%; P = 0.04). In conclusion, a history of BS was associated with higher rates of delisting on the waiting list as well as lower survival from the time of listing on ITT analysis. Presence of malnutrition and sarcopenia among patients with BS may contribute to worse outcomes.

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“…Malnutrition has become increasingly common in end-stage liver disease [ 1 ]. The prevalence of malnutrition has been reported in a significant proportion of patients with cirrhosis and ranges from 10% to 100%, contingent on severity of hepatic decompensation in the setting of cirrhosis [ 2 , 3 ]. However, even with this high occurrence, malnutrition is still under-diagnosed and ineffectively treated [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Optimizing the Nutritional Support of Adult Patients in the Setting of Cirrhosis

et al. 2017

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Aim: The aim of this work is to develop a pragmatic approach in the assessment and management strategies of patients with cirrhosis in order to optimize the outcomes in this patient population. Method: A systematic review of literature was conducted through 8 July 2017 on the PubMed Database looking for key terms, such as malnutrition, nutrition, assessment, treatment, and cirrhosis. Articles and studies looking at associations between nutrition and cirrhosis were reviewed. Results: An assessment of malnutrition should be conducted in two stages: the first, to identify patients at risk for malnutrition based on the severity of liver disease, and the second, to perform a complete multidisciplinary nutritional evaluation of these patients. Optimal management of malnutrition should focus on meeting recommended daily goals for caloric intake and inclusion of various nutrients in the diet. The nutritional goals should be pursued by encouraging and increasing oral intake or using other measures, such as oral supplementation, enteral nutrition, or parenteral nutrition. Conclusions: Although these strategies to improve nutritional support have been well established, current literature on the topic is limited in scope. Further research should be implemented to test if this enhanced approach is effective.

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Nutritional status and the performance of multiple bedside tools for nutrition assessment among patients waiting for liver transplantation: A Canadian experience

Cited by 28 publications

References 21 publications

The Anthropometric Assessment With the Bioimpedance Method Is Associated With the Prognosis of Cirrhotic Patients

The Anthropometric Assessment With the Bioimpedance Method Is Associated With the Prognosis of Cirrhotic Patients

Impact of Prior Bariatric Surgery on Perioperative Liver Transplant Outcomes

Optimizing the Nutritional Support of Adult Patients in the Setting of Cirrhosis

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