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Sato-Espinoza K, Chotiprasidhi P, Liza E, Placido-Damian Z, Diaz-Ferrer J. Evolution of liver transplantation in the metabolic dysfunction-associated steatotic liver disease era: Tracking impact through time. World J Transplant 2024; 14:98718. [DOI: 10.5500/wjt.v14.i4.98718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/19/2024] [Accepted: 08/23/2024] [Indexed: 09/20/2024] Open
Abstract
Liver transplantation (LT) for metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing globally due to rising rates of obesity and metabolic syndrome, posing significant challenges. MASLD patients typically present with advanced age, higher body mass index (BMI), and metabolic comorbidities such as diabetes, hypertension, and dyslipidemia. Comprehensive pre-transplant evaluations are crucial for assessing surgical risks and preparing patients for transplantation. MASLD patients with higher BMI may experience longer operative times, potentially affecting intraoperative outcomes. In the months following LT, MASLD recipients face persistent challenges, including a higher incidence of metabolic syndrome and cardiovascular events compared to non-MASLD recipients. However, survival rates at 1-, 3-, and 5-years post-LT do not markedly differ from other etiologies, indicating comparable surgical outcomes. Optimizing outcomes in MASLD patients undergoing LT demands a multidisciplinary approach from pre-transplant assessment to post-transplant care. Strategies must address metabolic comorbidities, manage cardiovascular health, and monitor steatosis recurrence, which can be exacerbated by obesity and diabetes. This approach aims to mitigate long-term graft complications and mortality risks, ultimately enhancing transplant success and patient well-being. Continued research is essential to refine these approaches and meet the evolving challenges posed by MASLD as a leading indication for LT worldwide.
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Affiliation(s)
- Karina Sato-Espinoza
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55902, United States
| | - Perapa Chotiprasidhi
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55902, United States
| | - Estefanía Liza
- Hepatology Service, Department of Digestive Diseases, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
| | - Zuly Placido-Damian
- Hepatology Service, Department of Digestive Diseases, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
| | - Javier Diaz-Ferrer
- Hepatology Service, Department of Digestive Diseases, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
- Medicine Faculty, Universidad San Martin de Porres, Lima 02002, Peru
- Gastroenterology Service, Clinica Internacional, Lima 02002, Peru
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Dos Santos JG, Saueressig C, Wolf R, Dos Santos JC, Silva FM, Franzosi OS, Alba VD. Identifying nutrition risk in emergency patients: What is the most appropriate screening tool? Nutr Clin Pract 2024; 39:911-919. [PMID: 38575550 DOI: 10.1002/ncp.11147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The emergency department (ED) is the most frequent access route to the hospital. Nutrition risk (NR) screening allows the early identification of patients at risk of malnutrition. This study aimed to evaluate the feasibility and predictive validity of five different tools in EDs: Nutritional Risk Screening 2002 (NRS-2002), Nutritional Risk Emergency 2017 (NRE-2017), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), Malnutrition Universal Screening (MUST), and Malnutrition Screening Tool (MST). METHODS Patients with scores ≥3 according to the NRS-2002, ≥1.5 according to the NRE-2017, and ≥2 according to the MUST, RFH-NPT, or MST were classified with NR. Prolonged length of stay (LOS) and 1-year mortality were evaluated. RESULTS 431 patients were evaluated (57.31 ± 15.6 years of age; 54.4% women) in a public hospital in southern Brazil. The prevalence of NR was: 35% according to the NRS-2002, 43% according to the MST, 45% according to the NRE-2017 and MUST, and 49% according to the RFH-NPT. Patients with NR, had a greater risk of prolonged LOS (P < 0.001). The presence of NR was associated with an increased risk of 1-year mortality according to the NRS-2002 (hazard ratio [HR]: 4.04; 95% CI, 2.513-6.503), MST (HR: 2.60; 95% CI, 1.701-3.996), NRE-2017 (HR: 4.82; 95% CI, 2.753-8.443), MUST (HR: 4.00; 95% CI, 2.385-6.710), and RFH-NPT (HR: 5.43; 95% CI, 2.984-9.907). CONCLUSIONS NRE-2017 does not require objective data and presented predictive validity for all outcomes assessed, regardless of the severity of the disease, and thus appears to be the most appropriate tool for carrying out NR screening in the ED.
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Affiliation(s)
- Johnny Galhano Dos Santos
- Graduate Program in Food, Nutrition, and Health, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Camila Saueressig
- Graduate Program Sciences in Gastroenterology and Hepatology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Renata Wolf
- Nutrition Course, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jéssica Correa Dos Santos
- Nutrition Course, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávia Moraes Silva
- Nutrition Department and Graduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Oellen Stuani Franzosi
- Nutrition and Dietetics Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Valesca Dall' Alba
- Graduate Program in Food, Nutrition, and Health, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program Sciences in Gastroenterology and Hepatology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Nutrition Course, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Nutrition and Dietetics Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Toledo E, Canal G, Sánchez S, Echeverri J, Fernández R, Del Mar Achalandabaso M, Anderson EJ, Castillo F, Rodríguez JC. Comparison of abdominal adipose tissue versus body mass index (BMI) as a predictor of complications and survival in liver transplantation. Cir Esp 2024; 102:322-330. [PMID: 38508388 DOI: 10.1016/j.cireng.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Because of the obesity epidemic, more obese patients are on liver transplant (LT) waiting lists. The diseases associated with obesity may increase complications and limit survival after LT. However, there is no established measure or cut-off point to determine this impact and aid decision making. The aim of the present study is to evaluate obesity in patients undergoing LT via BMI and CT-based measurement of adipose tissue (AAT). These parameters will be used to predict the risk of postoperative complications and 5-year survival. METHODS A retrospective, single-center study was carried out at a tertiary Spanish hospital, including all patients who received LT between January 2012 and July 2019 (n = 164). The patients were adults who underwent LT using the 'piggyback' technique, preserving the recipient vena cava. Visceral adipose tissue (VAT) and BMI were calculated to examine correlations with postoperative complications and 5-year survival. RESULTS No significant association was found between postoperative complications by Comprehensive Complication Index, BMI, AAT/height, subcutaneous fat/height and VAT/height. Kaplan-Meier curves for 5-year survival compared LT recipients with BMI < 30.45 versus ≥30.45, with an estimated survival of 58.97 months versus 43.11 months, respectively (P < .001) (Fig. 3) and for LT recipients with an AAT/height <27.35 mm versus ≥27.35 mm, with an estimated survival of 57.69 months versus 46.34 months (P = .001). CONCLUSIONS This study does not show a higher rate of postoperative complications in obese patients. There is a significantly lower long-term survival in patients with AAT/height ≥27.35 mm and BMI ≥ 30.45. BMI is a valid estimate of obesity and is predictive of survival.
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Affiliation(s)
- Enrique Toledo
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain.
| | - Gema Canal
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | | | - Juan Echeverri
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | - Roberto Fernández
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | | | - Edward J Anderson
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | - Federico Castillo
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain
| | - Juan Carlos Rodríguez
- General Surgery, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, Spain; Universidad de Cantabria, Cantabria, Spain
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Mian MUM, Kennedy CE, Coss-Bu JA, Javaid R, Naeem B, Lam FW, Fogarty T, Arikan AA, Nguyen TC, Bashir D, Virk M, Harpavat S, Galvan NTN, Rana AA, Goss JA, Leung DH, Desai MS. Estimating risk of prolonged mechanical ventilation after liver transplantation in children: PROVE-ALT score. Pediatr Transplant 2024; 28:e14623. [PMID: 37837221 DOI: 10.1111/petr.14623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 07/11/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Children at high risk for prolonged mechanical ventilation (PMV) after liver transplantation (LT) need to be identified early to optimize pulmonary support, allocate resources, and improve surgical outcomes. We aimed to develop and validate a metric that can estimate risk for Prolonged Ventilation After LT (PROVE-ALT). METHODS We identified preoperative risk factors for PMV by univariable analysis in a retrospective cohort of pediatric LT recipients between 2011 and 2017 (n = 205; derivation cohort). We created the PROVE-ALT score by mapping multivariable logistic regression coefficients as integers, with cutoff values using the Youden Index. We validated the score by C-statistic in a retrospectively collected separate cohort of pediatric LT recipients between 2018 and 2021 (n = 133, validation cohort). RESULTS Among total 338 patients, 21% (n = 72) were infants; 49% (n = 167) had cirrhosis; 8% (n = 27) required continuous renal replacement therapy (CRRT); and 32% (n = 111) required management in hospital (MIH) before LT. Incidence of PMV post-LT was 20% (n = 69) and 3% (n = 12) required tracheostomy. Independent risk factors (OR [95% CI]) for PMV were cirrhosis (3.8 [1-14], p = .04); age <1-year (8.2 [2-30], p = .001); need for preoperative CRRT (6.3 [1.2-32], p = .02); and MIH before LT (12.4 [2.1-71], p = .004). PROVE-ALT score ≥8 [Range = 0-21] accurately predicted PMV in the validation cohort with 73% sensitivity and 80% specificity (AUC: 0.81; 95% CI: 0.71-0.91). CONCLUSION PROVE-ALT can predict PMV after pediatric LT with a high degree of sensitivity and specificity. Once externally validated in other centers, PROVE-ALT will empower clinicians to plan patient-specific ventilation strategies, provide parental anticipatory guidance, and optimize hospital resources.
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Affiliation(s)
- Muhammad Umair M Mian
- Division of Child Health, University of Missouri School of Medicine, Springfield Clinical Campus, Columbia, Missouri, USA
| | - Curtis E Kennedy
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Jorge A Coss-Bu
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ramsha Javaid
- Division of Child Health, University of Missouri School of Medicine, Springfield Clinical Campus, Columbia, Missouri, USA
| | - Buria Naeem
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Fong Wilson Lam
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Thomas Fogarty
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ayse A Arikan
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Pediatrics, Division of Nephrology, Baylor College of Medicine, Houston, Texas, USA
| | - Trung C Nguyen
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Dalia Bashir
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Manpreet Virk
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Sanjiv Harpavat
- Department of Pediatrics, Division of Gastroenterology, Baylor College of Medicine, Houston, Texas, USA
| | - Nhu Thao Nguyen Galvan
- Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Abbas A Rana
- Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - John A Goss
- Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Daniel H Leung
- Department of Pediatrics, Division of Gastroenterology, Baylor College of Medicine, Houston, Texas, USA
| | - Moreshwar S Desai
- Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
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Roden-Foreman JS, Foreman ML, Monday K, Lingle K, Blough B, Safa MM, Schwartz G. Body mass index is not associated with time on veno-venous extracorporeal membrane oxygenation or in-hospital mortality. Perfusion 2023:2676591231193269. [PMID: 37501258 DOI: 10.1177/02676591231193269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Morbid obesity, as characterized by BMI, is often utilized as an exclusion criterion for VV-ECMO because of presumed poor prognosis and technically complex cannulation. However, the "obesity paradox" suggests obesity may be protective during critical illness, and BMI does not capture variations in body type, adiposity, or fluid balance. This study examines relationships between BMI and patient outcomes. Adult VV-ECMO patients with BMI ≥ 35 kg/m2 admitted January 2012 to June 2021 were identified from an institutional registry. BMI and outcomes were analyzed with Mann-Whitney U tests and Pearson correlations with Bayesian post-hoc analyses. 116 of 960 ECMO patients met inclusion criteria. Median (Q1, Q3) BMI was 42.3 (37.3, 50.8) and min, max of 35.0, 87.8 with 9.0 (5.0, 15.5) ECMO days. BMI was not significantly correlated with ECMO days (r = -0.102; p = .279). Bayesian analyses showed moderate evidence against BMI correlating with ECMO days. In-hospital mortality (27%) was significantly associated with ECMO days (p = .014) but not BMI (p = .485). In this cohort of high-BMI patients, BMI was not associated with survival or time on ECMO. BMI itself should not be used as an exclusion criterion for VV-ECMO.
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Affiliation(s)
- Jordin S Roden-Foreman
- Baylor University Medical Center at Dallas, Dallas, TX, USA
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | - Kara Monday
- Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - Kaitlyn Lingle
- Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - Britton Blough
- Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - Mohamad M Safa
- Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - Gary Schwartz
- Baylor University Medical Center at Dallas, Dallas, TX, USA
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Alves BC, Luchi-Cruz MM, Lopes AB, Saueressig C, Dall'Alba V. Predicting dry weight in patients with cirrhotic ascites undergoing large-volume paracentesis. Clin Nutr ESPEN 2023; 54:34-40. [PMID: 36963881 DOI: 10.1016/j.clnesp.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 12/26/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Ascites impairs the correct diagnosis and nutritional management in patients with cirrhosis, because the body weight, which is needed for nutritional assessment and calculation of nutritional needs, is overestimated. To adjust the weight in patients with ascites, dietetic guidances indicate substracting 2.2-14 kg or 5-15% of the measured body weight according to the degree of ascites, however, there is a lack of evidence to substantiate these values. The aim of this study was to develop new prediction equations to estimate the dry weight, comparing them with the currently used weight adjustments in patients with refractory cirrhotic ascites. METHODS Cross-sectional study, that included patients with decompensated cirrhosis undergoing large-volume paracentesis. Patients were submitted to nutritional risk screening, nutritional assessment, and anthropometric measurements that included body weight, abdominal circumference (both measured before and after paracentesis) height, and upper mid-arm circumference. The volume of ascitic fluid drained was also registered. For the predictions of dry weight, linear regression models were performed using as predictor variables: height, pre-paracentesis weight, pre-paracentesis abdominal circumference, or mid-upper arm circumference, and as response variable: post-paracentesis weight. The capacity of these models to predict the post-paracentesis weight was evaluated by comparing it with the currently used predictions through the intraclass correlation coefficient (ICC) and the mean squared error (MSE). RESULTS Nineteen patients were included, 15 male, and 18 with high nutritional risk and malnutrition. The difference between post-paracentesis weight and pre-paracentesis weight was -5.0 (-3.6 to -9.9) kg, similar to ascitic fluid volume drained. Two equations were developed to predict post-paracentesis weight. ICC values showed that both prediction equations were strongly correlated (r > 0.94) with post-paracentesis weight. Our models also showed lower MSEs (<17.97), compared with the current predictions (MSEs <64.19, when the pre-paracentesis weight is adjusted from absolute values and MSEs <33.24 when adjusted from percentage values), indicating a more accurate prediction. CONCLUSION The predictive equations from this study may be better options for dry weight estimation in patients with refractory cirrhotic ascites since they showed higher reliability compared to the currently used weight adjustment. External validation in a larger sample is still needed to confirm the clinical applicability of these equations.
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Affiliation(s)
- Bruna Cherubini Alves
- Graduate Program: Sciences in Gastroenterology and Hepatology, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Antonio Barros Lopes
- Graduate Program: Sciences in Gastroenterology and Hepatology, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Division of Gastroenterogy and Hepatology, Hospital de Clínicas de Porto Alegre; Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Saueressig
- Graduate Program: Sciences in Gastroenterology and Hepatology, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Valesca Dall'Alba
- Graduate Program: Sciences in Gastroenterology and Hepatology, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Undergraduate Nutrition Course, School of Medicine, UFRGS; Porto Alegre, Rio Grande do Sul, Brazil; Division of Nutrition and Dietetics, Hospital de Clínicas de Porto Alegre; Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, School of Medicine, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil.
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Saueressig C, Luft VC, Dall'Alba V. Measurement of mid-arm circumference as a starting point for nutritional assessment of patients with decompensated cirrhosis: A prospective cohort study. J Hum Nutr Diet 2023; 36:116-125. [PMID: 35822512 DOI: 10.1111/jhn.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/27/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The mid-arm circumference (MAC) is an accessible, quick, and inexpensive measurement, which can be performed at the bedside only with a measuring tape. In this sense, the present study aims to suggest MAC cut-off values to assess the nutritional status and its association with mortality of hospitalised patients with decompensated cirrhosis. METHODS A prospective cohort study was performed with decompensated cirrhotic patients. Nutritional status was assessed by MAC and Subjective Global Assessment (SGA). Considering the SGA as the reference standard and based on receiver operating characteristic curve analysis, the MAC cut-off values with the best sensitivity and specificity were selected. Predictors of mortality were identified using multivariate analysis. RESULTS The study included 100 patients with a mean ± SD age of 60.1 ± 10.3 years. The median follow-up time was 11.2 months and overall mortality was 60%. Considering malnutrition assessed by SGA as the reference standard, the area under the curve of MAC for women and men was 0.947 (95% confidence interval [CI] = 0.878-1.000) and 0.813 (95% CI = 0.694-0.932). The MAC cut-off values of ≤ 28 cm for women and ≤ 30 cm for men reached a sensitivity and specificity of 85.5% and 71%, respectively. According to multivariate analysis, a low MAC was significantly associated with mortality (hazard ratio = 2.41; 95% CI = 1.20-4.84). CONCLUSIONS The MAC cut-off values had satisfactory accuracy for men and women in predicting malnutrition. Additionally, a low MAC was an independent predictor of mortality. Thus, these MAC cut-off values can be used as the first step of nutritional assessment to prioritise patients who require more detailed assessment.
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Affiliation(s)
- Camila Saueressig
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil
| | - Vivian C Luft
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil.,Graduate Program in Food, Nutrition, and Health, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil.,Department of Nutrition, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil.,Nutrition and Dietetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Valesca Dall'Alba
- Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil.,Graduate Program in Food, Nutrition, and Health, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil.,Department of Nutrition, Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Porto Alegre, Brazil.,Nutrition and Dietetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Ayele T, Gebremickael A, Alemu Gebremichael M, George M, Wondmagegn H, Esubalew H, Bukala Z, Meskele S, Abebe G, Bekele A. Ultrasonographic Determination of Portal Vein Diameter Among Adults with and without Chronic Liver Disease at Selected Referral Hospitals in Southern Ethiopia. Int J Gen Med 2022; 15:45-52. [PMID: 35046700 PMCID: PMC8760923 DOI: 10.2147/ijgm.s342087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Tsegazeab Ayele
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abinet Gebremickael
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mathewos Alemu Gebremichael
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Mala George
- Department of Biochemistry, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Habtamu Wondmagegn
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Correspondence: Habtamu Wondmagegn P.O. Box No: 21, Arba Minch, EthiopiaTel +251 913028959Fax +251 468810279 Email ;
| | - Habtamu Esubalew
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Zekarias Bukala
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Simeon Meskele
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Getachew Abebe
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Alehegn Bekele
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Langley-Evans SC. Nutrition screening tools: Still no consensus 40 years on. J Hum Nutr Diet 2021; 34:923-925. [PMID: 34783403 DOI: 10.1111/jhn.12952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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