Evaluation of Screening for Malnutrition Risk Assessment of Chronic Liver Disease Inpatients

Abstract

Background: Malnutrition is common in all stages of chronic liver disease (CLD). Its early detection can improve liver function; and reduce the risk of nosocomial infection, morbidity and mortality. Although malnutrition has been well understood and appreciated, it is nevertheless prevalent in hospitals because nutritional status is often overlooked in favor of pressing acute complications. The present study aimed to evaluate screening for malnutrition risk assessment (MRA) in CLD inpatients of Theodor Bilharz Research Institute (TBRI). Materials and methods: A hospital-based crosssectional retrospective analytical study was conducted to assess health records for MRA activities provided to CLD inpatients, men (n=61) and women (n=39). CLD severity was determined by Child– Pugh model for end-stage liver disease. The MRA checklist was created with reference to the 2002 European Society of Parenteral and Enteral Nutrition (ESPEN) standards for nutritional therapy in hospitals. Results: The present study revealed the absence of an organized schedule for diagnoses of MRA; in favor of managing pressing CLD complications starting with the absence of history taking and anthropometric measurements. Only apparent malnutrition signs such as ascites, lower limb edema, and Sodium retention were detected. Also, there is a lack of a lab investigation for subclinical signs and lab of protein-energy malnutrition, and macro and micronutrient deficiencies.
Conclusions: Supplementation of vitamins and micronutrients was empirically prescribed. Despite the common association of CLD patients with malnutrition, there was an absence of clearly stated MRA schemes and delegated responsibilities.