Determining the frequency and severity of malnutrition and correlating it with the severity of liver cirrhosis

Background/aims: Malnutrition is a significant problem in cirrhosis of the liver worldwide. Inadequate data is available on the nutritional status of Pakistani patients. This study aimed to determine the frequency and severity of malnutrition in patients having cirrhosis of the liver and to compare the degree of malnutrition with the severity of liver disease. Materials and Methods: Two hundred ninety-eight patients with liver cirrhosis were included in the study. Nutritional status was assessed using the Royal Free Hospital Global Assessment scheme for cirrhotics. The patients were categorized into well-nourished, and mild to moderately and severely malnourished. Various degrees of malnutrition were compared with severity of disease according to Child-Pugh staging. Results: In the 298 patients with liver cirrhosis, hepatitis C (54,36%) and B (35,90%) were the commonest aetiologies, followed by autoimmune hepatitis (3,35%), primary billiary cirrhosis (2,34%), Wilson's disease (1,34%), haemochromatosis (1,0%), cryptogenic cirrhosis (1,0%), and alcohol being the rare cause (0,67%). 14,42% patients were well-nourished, (54,02%) were mild to moderately malnourished and (31,54%) were severely malnourished. Malnutrition is more frequent in virus-related cirrhosis, and the degree of malnutrition increases with increasing clinical severity as assessed by Child- Pugh stages with statistically significant p-value of 0.001. Conclusion: Moderate to severe malnutrition among diverse aetiologies of cirrhosis is quite common in Pakistan. The degree of malnutrition increases with increasing clinical severity of cirrhosis of liver.