Effect of Nutritional Status on Coagulation and Inflammation in Patients With Cirrhosis and Variceal Bleeding

BACKGROUND Malnutrition is a serious concern in patients with liver cirrhosis that is complicated by acute variceal bleeding due to portal hypertension. The Controlling Nutritional Status (CONUT) score is a screening tool used to evaluate altered nutritional status and predict adverse outcomes in patient populations. This study aimed to assess nutritional status using the CONUT score in 151 patients with cirrhosis and esophageal-gastric variceal bleeding (EVB). MATERIAL AND METHODS Clinical data from 151 patients with cirrhotic EVB admitted between January 2023 and October 2024 were analyzed. Nutritional status was assessed using the CONUT score. General linear model analysis was used to explore associations between nutritional, coagulation, and inflammatory indices. RESULTS Based on CONUT scores, 2.6% (n=4) of patients had normal nutrition, 15.9% (n=24) had mild malnutrition, and 81.5% (n=123) had moderate-to-severe malnutrition. Patients showed significant coagulation impairment, including prolonged prothrombin time (PT) and international normalized ratio (INR), reduced prothrombin activity (PTA), and elevated D-dimer (all P<0.05). Inflammatory markers, including interleukin-6 (IL-6), were also significantly elevated (P<0.05). CONUT scores were positively correlated with PT (rs=0.508, P<0.05), INR (rs=0.515, P<0.05), and IL-6 (rs=0.211, P<0.05) and negatively correlated with PTA (rs=-0.432, P<0.05). General linear model analysis identified PT (OR=1.214), INR (OR=0.172), D-dimer (OR=3.460), and IL-6 (OR=1.439) as independent risk factors for malnutrition (all P<0.05). CONCLUSIONS Moderate-to-severe malnutrition is highly prevalent in patients with cirrhotic EVB and is independently associated with coagulation dysfunction and systemic inflammation. These findings highlight the need for strengthened nutritional monitoring and individualized interventions to improve patient prognosis.