Disease-related malnutrition is a health problem with high prevalence and associated
costs. Poor nutritional status has an unfavorable effect on clinical outcomes in terms of
complications, post-transplant survival and mortality in relation to the liver, in
addition to a decrease in quality of life. The same complications of liver disease, such
as hypoalbuminemia or ascites, make it difficult to assess malnutrition in cirrhotic
patients.
The use of screening tools defines the first step in the prevention and treatment of
patients at risk of malnutrition or overt malnutrition. The use of screening tools to
detect malnutrition upon admission to hospital improves the identification of
malnourished patients by 50-80%, early treatment of patients can reduce hospital stay. It
has been observed that nutritional interventions, after assessment of nutritional risk,
appear to prevent complications and improve quality of life and survival rate in
cirrhotic patients.
Due to changes in body composition in cirrhotic patients (i.e. ascites), the most common
questionnaires for screening for malnutrition (e.g. MUST, NRS-2002), which use
anthropometric measures, have not been validated in cirrhosis and are therefore not
considered suitable for malnutrition screening. On the contrary, in recent years two
specific nutritional screening tools have been developed for cirrhotic patients, the
Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) and the Liver Disease
Undernutrition Screening Tool (LDUST). Both questionnaires, however, require further
validation against clinical outcomes in cirrhotic patients.
This study will use two screening tools for malnutrition risk (RFH-NPT and LDUST), to
compare their validity in detecting malnutrition risk in patients with liver cirrhosis.
These tools will be validated by performing a nutritional assessment with the new
diagnostic criteria of malnutrition promoted by the Global Leadership Initiative on
Malnutrition.
Sarcopenia can occur in malnourished cirrhotic patients, so it will be of interest to
know what the possible prevalence may be in the sample of patients studied. The use of
the screening questionnaire SARC-F will allow an assessment of the prevalence of risk of
sarcopenia. Situations such as malnutrition or sarcopenia can have an impact on the
patient's health-related quality of life, so this parameter will be assessed using the
Chronic Liver Disease Questionnaire.
