Analysis Of Factors Associated With The Risk Of Malnutrition In Patients With Liver Cirrhosis

Objective:The Nutrition Risk Screening 2002 scale(NRS-2002)was used to explore the risk of malnutrition in hospitalized cirrhotic patients,to analyze the factors influencing the risk of malnutrition in cirrhotic patients and risk factors,and to explore the value of serological markers for early screening of the risk of malnutrition in cirrhosis.Methods:From December 2021 to January 2023,210 patients with liver cirrhosis were enrolled in the study at the Inner Mongolia Medical University Affiliated Hospital and baseline data such as sex,age,height,weight and previous medical history were collected after admission.Measurement and calculation of relevant anthropometric indicators such as triceps skinfold thickness(TSF),upper arm circumference(AC),calculation of upper arm muscle circumference(AMC),patient body mass index(BMI).At the same time,collect relevant laboratory indicators,including blood routine,liver and kidney function,electrolyte,etc.Improve the corresponding abdominal imaging examination,and collect data such as ChildPugh classification and complications.In view of these 210 patients,we conducted an investigation through the Nutrition Risk Screening 2002(NRS-2002),and the statistical score was < 3 for the malnutrition group,and ≥3 for the non-malnutrition group.Univariate analysis,binary and multivariate logistic regression were used to assess the factors influencing the risk of developing malnutrition in patients with cirrhosis and risk factors,and to explore the value of serological markers for early screening of malnutrition risk in cirrhosis.Results:1.According to the NRS-2002 grouping,there were statistically significant differences in BMI,AC,AMC,serum total lymphocyte count(LYM),hemoglobin(HGB),total protein(TP),albumin(ALB),aspartate aminotransferase(AST),aspartate aminotransferase/alanine aminotransferase(AST/ALT),total bilirubin(There were statistically significant differences in serum potassium(K),serum sodium(Na),serum chloride(CL)and serum calcium(Ca)at P<0.05.The differences in gender,age,etiology and TSF in general data between the two groups were not statistically significant at P>0.05;serum alkaline phosphatase(ALT),alkaline phosphatase(ALP),serum phosphorus(P),serum magnesium(Mg),fasting glucose(FPG),and creatinine(SCr)levels were not statistically different,P>0.05.The rates of combined complications,ascites,hepatic encephalopathy,and Child-Pugh grade B/C were higher in the group with malnutrition risk than in the group without malnutrition risk,all P<0.05;the rates of bleeding,infection,and portal vein thrombosis were not statistically significant differences,P>0.05.2.Multifactorial Logistic regression analysis showed that the results indicated that AMC,LYM,HGB,comorbidities,and Child-Pugh classification were influential factors for having malnutrition risk.AMC(OR=0.744,95% CI=0.595 to 0.930),LYM(OR=0.003,95% CI=0.00`to 0.037),and HGB(OR=0.946,95% CI=0.918 to 0.976)were protective factors for the risk of developing cirrhotic malnutrition.Comorbidities(OR= 44.753,95%CI= 10.333～193.829)and Child-Pugh class B/C(OR=20.850,95%CI=3.773～115.223)were independent risk factors for the risk of malnutrition in patients with cirrhosis.Conclusion:The detection rate of malnutrition risk in our inpatients with cirrhosis was 49.05% as screened by the NRS-2002 nutritional risk screening form.The group with malnutrition risk had lower anthropometric and electrolyte levels,higher liver function levels,more Child-Pugh B/C classes,and a higher incidence of comorbidities,especially combined ascites and hepatic encephalopathy,compared to the group without malnutrition risk.When patients with cirrhosis have reduced AMC,reduced HBG,reduced LYM,Child-Pugh class B/C,and comorbidities,clinicians are advised to promptly conduct nutritional screening and individualized nutritional interventions.