LAUSR

Malnutrition is common in cirrhosis and is associated with a worse prognosis. This study aimed to evaluate the nutritional status by mid-arm circumference (MAC) and the association between MAC and mortality in patients with decompensated cirrhosis. This is a prospective cohort study performed with hospitalized decompensated cirrhotic patients. Nutritional status was assessed within 72 hours of admission, from April 2017 to April 2018. Patients with values of MAC ≤5th percentile were considered malnourished. Survival over time was estimated using Kaplan-Meier curves and significant predictors of 30-days and long-term mortality were identified using Cox proportional hazards models. One-hundred patients with an average age of 60.1 ± 10.3 years were evaluated. Of these, 63% were male. The presence of ascites was the most observed complication with a prevalence of 69%, followed by variceal bleeding in 24% and hepatic encephalopathy in 22%. The median of follow-up time of patients was 11.2 months (range, 2.4–21). Overall mortality was 60% and mortality in 30-days was 16%. Malnourished patients through MAC (30%) were significantly more likely to die in either follow-up of 30-days (Log-rank value: 0.008) and long-term mortality (Log-rank value: 0.001). The 30-days probabilities of survival were 70% in patients malnourished by MAC compared to 90% in patients with MAC values > 5th percentile. In multivariate analysis, after adjustment for age and Child-Pugh score, patients with malnutrition had a higher risk of 30-days mortality (HR: 3.64; 95% CI 1.33–9.95; P = 0.012) and after total period of follow-up (HR: 2.21; 95% CI 1.30–3.73; P < 0.001). Higher values of MAC were associated with a reduced overall mortality risk in 30-days and long-term of 15% and 8%, respectively. Malnutrition, assessed by a simple bedside anthropometric parameter, can predict short-term and long-term follow-up mortality risk in patients with decompensated cirrhosis. Therefore, MAC may be an efficacious tool to assess nutritional status and identify patients with a high risk of mortality. This study was supported by a CAPES and FIPE/HCPA scholarship. The sources of funding were not involved in study design; in collection, analysis and interpretation of the data.