Bedside Nutritional assessment in cirrhotic patients using Mini Nutritional Assessment proforma: A cross-sectional study

Abstract: Introduction:Liver cirrhosis often results in malnutrition due to impaired nutrient intake and metabolism, increasing morbidity and mortality. Early identification of malnutrition is crucial to prevent complications. This study aimed to assess the nutritional status of cirrhotic patients using the Mini Nutritional Assessment (MNA) tool. Aims and Objectives:To evaluate the prevalence of malnutrition among patients with chronic liver disease (CLD) using the MNA and identify factors associated with malnutrition. Place and Duration of Study:This study was conducted at the Department of Gastroenterology, HMC Peshawar, from September 2022 to July 2023. Materials and Methods:A cross-sectional study was conducted, enrolling 330 patients aged ?18 years with diagnosed liver cirrhosis. Patients with malignancies and advanced hepatic encephalopathy (grades 3 and 4) were excluded. Data were collected through anthropometric measurements including Body Mass Index (BMI), Mid Arm Circumference (MAC), and Triceps Skinfold Thickness (TSF). MNA scoring was used to evaluate nutritional status, and disease severity was assessed using the Child-Pugh score. Statistical analyses were performed to assess relationships between malnutrition and clinical variables. Results:The mean age of the patients was 54.73 ± 11.79 years, with a mean BMI of 22.41 ± 2.76 and a mean MNA score of 19.03 ± 4.43. Malnutrition was more prevalent in older patients (p=0.001), those with hepatitis B (p=0.002), advanced cirrhosis (Child-Pugh B and C, p=0.000), and those with moderate to severe ascites (p=0.000). Ascites and hepatic encephalopathy were identified as significant predictors of malnutrition in logistic regression analysis. Conclusions:Malnutrition is highly prevalent in cirrhotic patients, especially those with advanced disease and complications like ascites. Routine nutritional screening using the MNA can help in early identification and management of malnutrition, improving patient outcomes.