Prospective study evaluating the value of subjective global assessment and national risk score 2002 for post-operative risk detection in living related donor liver transplant recipients

Background: Chronic liver disease may be associated with protein energy malnutrition. Those malnourished patients undergoing liver transplantation suffer great morbidities and even mortalities. Estimating the degree of malnutrition in patients with end stage liver disease is a difficult job, Subjective Global Assessment (SGA) and Nutritional Risk Score-2002 (NRS-2002) are among many tools that can give an overview for the nutritional status of the patients. Aim: To detect the efficacy and the predictive validity of SGA and NRS 2002 for post-operative risk detection for liver transplant patients. Patients & Methods: 30 recipients of end stage liver disease had undergone a nutritional assessment by SGA score & NRS-2002 score, to be compared with the parameters of outcome of post-operative liver transplantation (ALT, AST, INR, Bilirubin, time spent in ICU, hospital infective episodes & number of antibiotic courses). Results: Patients declared as malnourished by SGA and NRS-2002 had higher post operative ALT & AST value, more prolonged INR, spent more time at ICU and hospital, suffered from more infective episodes and had more antibiotic courses in a significant statistical manner. Conclusion: SGA and NRS-2002 could be useful, simple and dependable tools to be used for risk detection of post-operative morbidities after liver transplantation.

新疆地区不同民族肝癌患者欧洲营养风险筛查2002(NRS2002)情况调查

目的比较欧洲营养风险筛查2002(Nutritional Risk Screening,NRS2002)在新疆地区不同民族肝癌患者营养筛查的结果差异及其与预后的相关性。方法采用连续定点抽样的方法,收集2010年1-12月在新疆医科大学第一附属医院肿瘤中心就诊的肝癌患者351例新疆不同民族肝癌患者,在入院次日清晨采用NRS2002量表进行营养筛查,进行后续随访,比较不同民族患者的营养状况及其与预后的关系。结果 351例肝癌患者均完成调查,BMI评定为营养不足、超重和肥胖的发生率分别为11.68%、6.55%、4.84%,男性分别为12.99%、6.50%、12.33%,女性分别为6.76%、6.76%、6.76%,男性患者和女性患者差异无统计学意义(P=0.431)。汉族患者分别为12.59%、6.64%、3.15%,维吾尔族患者分别为11.76%、8.82%、14.71%,其他少数民族患者分别为3.23%、3.23%、9.67%,汉族和维吾尔族患者筛查结果差异有统计学意义(P=0.017);新疆肝癌患者NRS2002筛查提示营养风险的发生率为58.69%,男性患者为64.26%,女性患者为47.30%,不同性别肝癌患者营养风险发生率差异有统计学意义(P=0.011)。汉族患者营养风险发生率为60.84%,维吾尔族患者营养风险发生率为35.29%,其他少数民族营养风险发生率为64.52%,汉族患者营养风险发生率高于维吾尔族患者(P=0.006);生存分析显示,有营养风险的患者预后较差(P<0.05)。结论不同民族肝癌患者的营养状况存在差异,并且这种差异与预后相关。