Malnutrition Impacts Health-Related Quality of Life in Cirrhosis: A Cross-Sectional Study

Background To explore the influence of nourishment state measured by various nutrition assessment tools (NATs) on health-related quality of life (HRQoL) in a pretransplant population with cirrhosis. Methods We collected demographic, nutrition assessment, and disease specific data on 81 patients. HRQoL was measured with the Short-Form 36 and divided into 8 subscales. Significant relationships between NATs and HRQoL were examined using independent sample t-tests, chi(2) analyses, correlations, and multiple and logistic regression adjusted for age and gender. Results Study mean age was 54.2 years (SD 10.4 years), and 57% were male. Subjective Global Assessment (SGA) was significantly related to all HRQoL subscales, except bodily pain and mental health. In the adjusted regression models, general health, vitality, and social functioning were all significantly lower in patients with poorer nutrition status measured using SGA (adjusted R-2 = 11%, beta = -0.34, p < 0.01; adjusted R-2 = 8%, beta = -0.27, P < 0.05; and adjusted R-2 = 12%, beta = -0.38, P < 0.01, Q4 respectively). Physical functioning improved as hand grip strength increased (adjusted R-2 = 20%, beta = 0.36, P < 0.01). MELDNa demonstrated a significant negative relationship with role-emotional (adjusted R-2 = 3%, beta = 0.25, P < 0.05), and mid-arm circumference did not demonstrate any significant relationships with HRQoL. Conclusions Malnutrition assessed by SGA is associated with lower HRQoL in patients with cirrhosis. Future research should identify if nutrition interventions can effectively improve HRQoL in cirrhosis patients.