VA cooperative study on alcoholic hepatitis II: prognostic significance of protein-calorie malnutrition

Mendenhall, Charles L.; Tosch, Thomas J.; Weesner, Robert E.; Garcia-Pont, P.; Goldberg, Stephen J.; Kiernan, Thomas; Seeff, Leonard B.; Sorell, Michael; Tamburro, Carlo H.; Zetterman, Rowen K.

doi:10.1093/ajcn/43.2.213

Cited by 198 publications

(100 citation statements)

References 17 publications

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“…In the present study, the nutritional diagnosis was made using the PCM score proposed by MENDENHALL et al (23) which assigns value to the whole set of parameters used (23,24) .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, due to these complications and to the high prevalence of infections, these patients are in an important hypermetabolic state (22,23) . The changes explain the nutritional differences observed in this study and in others (19) among patients with compensated (Child A) and patients with more advanced disease (Child B and C).…”

Section: Discussionmentioning

confidence: 99%

“…These patients also are hypermetabolic due to these complications and to the increased incidence of infections (22,23) .…”

Section: Discussionmentioning

confidence: 99%

“…As also done by others (19,20,23,24) we decided to assign to a single group all patients with a history of alcoholism. In addition, all of these patient were heavy drinkers consuming large doses of alcohol which can cause PCM of themselves, as extensively demonstrated in the literature (15,22,24,29) .…”

Section: Discussionmentioning

confidence: 99%

“…The values obtained according to percentage of adequacy were classifi ed using the PCM score proposed by MENDENHALL et al (23) :…”

Section: Patient and Methodsmentioning

confidence: 99%

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Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis

Carvalho

Parise

2006

Arq. Gastroenterol.

121

107

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-Background -Protein-calorie malnutrition is a frequent fi nding in patients with chronic liver disease, but investigations of nutritional status have been rarely performed in individuals seen at outpatient clinics. Aim -To evaluate the nutritional status of patients with alcoholic and nonalcoholic cirrhosis, attended for the fi rst time at a reference outpatient clinic for liver diseases. Patients and methods -A total of 300 consecutive patients attended at the outpatient clinics of a reference center for liver diseases were investigated. Anthropometric evaluation was performed by the usual parameters: triceps skinfold, arm circumference and arm muscle circumference. Biochemical parameters included creatinine/height index, serum albumin and lymphocytes count. The nutritional diagnosis was based on the PCM score proposed by Mendenhall et al. Food intake was retrospectively evaluated using 24-hour dietary recall data. Results -About 71% of the patients studied were chronic alcohol abusers, whereas in 29% cirrhosis was of nonalcoholic etiology. Independently of the disease etiology 75.3% of the patients showed some degree of protein-calorie malnutrition, which was moderate or severe in 38.3% of them. More advanced protein-calorie malnutrition degrees were associated with lower energy and protein intake. The prevalence of moderate or severe protein-calorie malnutrition was higher in patients classifi ed as Child-Pugh C than in patients classifi ed as Child-Pugh A (21% x 58%, respectively). Regarding sexual differences, fat reserves, evaluated by triceps skinfold, were more depleted in females than in males (48.6% x 26.6%) regardless of the etiology of the cirrhosis, whereas muscle reserves (arm muscle circumference) were more depleted in males (43.4% x 13.4%) regardless of the etiology of cirrhosis. In contrast, cirrhosis of alcoholic etiology was determinant in reducing arm muscle circumference in females (20% x 9.1%).Conclusions -These data highlight the high prevalence of protein-calorie malnutrition occurring early in the natural history of the disease and accompanying functional hepatic deterioration. In addition, attention should be paid to the different gender patterns of response to protein-calorie malnutrition in these patients. HEADINGS -Nutritional status. Liver cirrhosis. Outpatients.

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“…In the present study, the nutritional diagnosis was made using the PCM score proposed by MENDENHALL et al (23) which assigns value to the whole set of parameters used (23,24) .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…These patients also are hypermetabolic due to these complications and to the increased incidence of infections (22,23) .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The values obtained according to percentage of adequacy were classifi ed using the PCM score proposed by MENDENHALL et al (23) :…”

Section: Patient and Methodsmentioning

confidence: 99%

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Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis

Carvalho

Parise

2006

Arq. Gastroenterol.

121

107

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Morbid Prognostic Features in Patients With Chronic Liver Failure Undergoing Nonhepatic Surgery

Rice

O’Keefe²,

Helton³

et al. 1997

Arch Surg

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We identified 8 clinical and laboratory variables associated with death within 30 days in patients with chronic liver failure undergoing nonhepatic surgery. Two factors-international normalized ratio greater than 1.6 and encephalopathy-independently predicted mortality by multivariate analysis. Neither Child classification nor Pugh score was prognostically helpful. Nonhepatic surgery confers a substantial mortality risk in patients with chronic liver failure.

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Alcoholic Liver Disease: Natural History, Diagnosis, Clinical Features, Evaluation, Prognosis and Management

Hadengue¹

2007

Textbook of Hepatology

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VA cooperative study on alcoholic hepatitis II: prognostic significance of protein-calorie malnutrition

Cited by 198 publications

References 17 publications

Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis

Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis

Morbid Prognostic Features in Patients With Chronic Liver Failure Undergoing Nonhepatic Surgery

Alcoholic Liver Disease: Natural History, Diagnosis, Clinical Features, Evaluation, Prognosis and Management

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