A total of 1,053 cirrhotic patients were included in a prospective study to determine whether malnutrition is a risk factor for mortality in cirrhotic patients.
Child-Pugh classification as well as clinical and biochemical variables were used to assess the severity of cirrhosis.
Nutritional status was evaluated both by anthropometric and clinical measurements.
Patients were defined as malnourished when midarm muscle area (MAMA) and/or midarm fat area (MAFA) were below the 5th percentile of an age-and sex-matched population.
During follow-up, 419 patients died.
The estimated survival rate was 82.7% at 1 year, 65.1% at 3 years, and 50.7% at 5 years.
The presence of muscle depletion and/or of a steep reduction in fat deposits was associated with a higher risk of mortality (midarm muscle area,<5th percentile, relative risk=1.79 ; midarm fat area,<5th percentile, relative risk=1.35).
When patients were stratified according to the Child-Pugh classification, cumulative survival was lower in patients with a reduction in muscle mass in Child-Pugh classes A and B (log rank : P=027 ; P=022, respectively) but not in class C. Conversely, a significant reduction in adipose tissue deposits appeared to have no independent impact on survival in any Child-Pugh class.
When examined using a multivariate Cox proportional hazard analysis, age, sex, bilirubin, cholinesterase, ascites, and esophageal varices were selected, whereas the parameters of nutritional status were not.
Mots-clés Pascal : Cirrhose, Foie, Effet biologique, Malnutrition, Survie, Facteur risque, Mortalité, Etude statistique, Homme, Appareil digestif pathologie, Foie pathologie, Trouble nutrition
Mots-clés Pascal anglais : Cirrhosis, Liver, Biological effect, Malnutrition, Survival, Risk factor, Mortality, Statistical study, Human, Digestive diseases, Hepatic disease, Nutrition disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0271915
Code Inist : 002B13C03. Création : 199608.