Differences in nutritional risk assessment between NRS2002, RFH-NPT and LDUST in cirrhotic patients

Peiyan Zhang; Qi Wang; Mengran Zhu; Pingping Li; Yuzhen Wang

doi:10.1038/s41598-023-30031-1

Differences in nutritional risk assessment between NRS2002, RFH-NPT and LDUST in cirrhotic patients

Sci Rep. 2023 Feb 27;13(1):3306. doi: 10.1038/s41598-023-30031-1.

Authors

Peiyan Zhang¹, Qi Wang^{1

2}, Mengran Zhu^{1

3}, Pingping Li¹, Yuzhen Wang⁴

Affiliations

¹ Department of Geriatric Gastroenterology, Hebei General Hospital, Shijiazhuang, 050000, China.
² Department of graduate academy, North China University of Science and Technology, Tangshan, 063000, China.
³ Graduate academy, Hebei North University, Zhangjiakou, 075000, China.
⁴ Department of Geriatric Gastroenterology, Hebei General Hospital, Shijiazhuang, 050000, China. wyzhen233@126.com.

Abstract

Nutritional status is an independent predictor of outcome in cirrhosis patients. Nutritional Risk Screening 2002 (NRS2002), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), and Liver Disease Undernutrition Screening Tool (LDUST) were employed to detect cirrhosis with malnutrition risk in this work. Meanwhile, their diagnostic performances were compared to find the best screening method. This work aimed to establish the sarcopenia cut-off value of the transversal psoas thickness index (TPTI), and identify the risk factors for malnutrition. Cirrhosis patients who were admitted to Heibei Gerneral hospital from April 2021 to October 2021 and underwent abdominal CT examination were enrolled. 78 patients were assessed by NRS2002, RFH-NPT, and LDUST. The Global Leadership Initiative for Malnutrition (GLIM) criteria were selected as the gold standard for the diagnosis of malnutrition. Meanwhile the cut-off value of sarcopenia was established based on the TPTI of malnourished patients. Logistic regression analysis was adopted to assess the influencing factors of malnutrition risk and malnutrition. The prevalence of malnutrition was 42.31%. The prevalence of malnutrition risk was 32.1%, 61.5%, and 62.8% with NRS2002, RFH-NPT, and LDUST, respectively. NRS2002 presented the best specificity compared with the other methods, while RFH-NPT showed the highest sensitivity. The optimal gender-specific TPTI cut-off value for diagnosing sarcopenia was determined as TPTI < 14.56 mm/m (male) and TPTI < 8.34 mm/m (female). In the multivariate analysis, ascites was associated with malnutrition risk, while sarcopenia showed a significant risk for malnutrition. NRS2002 and RFH-NPT were superior to LDUST at detecting the malnutrition in cirrhosis patients diagnosed according to GLIM criteria. The gender-specific TPTI cut-off value was TPTI < 14.56 mm/m (male) and TPTI < 8.34 mm/m (female). Malnutrition risk should be screened for patients with ascites as soon as possible. In addition, it was important to evaluate malnutrition in sarcopenia patients in time.

MeSH terms

Ascites
Digestive System Diseases*
Female
Hospitals
Humans
Liver Cirrhosis / complications
Liver Cirrhosis / diagnosis
Liver Diseases*
Male
Malnutrition* / diagnosis
Malnutrition* / epidemiology
Risk Assessment
Sarcopenia* / diagnosis
Sarcopenia* / epidemiology