Under nutrition is known to be associated with a greater risk of post operative complications and higher mortality rates in patients with liver disease. This study aims to improve the post operative outcome.
A retrospective study was conducted in ILC from January 2014 to March 2016.The participants were selected in the age group between 20 to 70years of age admitted to ILC were followed in the outpatient, inpatient liver care unit where liver transplant was indicated. Anthropometric nutritional evaluation for 113 patients were carried out .The assessment included were weight (kg), height (cm), mid arm circumference, MUAMC, TSF, HGMS and nutritional counseling was carried out to all patients. The mean, standard deviation were obtained for all anthropometric indicators which were continuous variables. Statistical analysis using Kolmogrov test were performed
RESULTS AND DISCUSSION
There were 97% male, 15% female aged 48.3±11.2 out of 113 patients. The mean BMI, TSF, MAC, MUAMC, HGMS, weight loss were 22.6±17.7,37.6±16.7 ,28.25±10.5,37.6±22.2,30.8±14.7,23±11.5 respectively.15.9%,23.8%,41.5%,18.8% patients nutritional status were normal, mild, moderate, severe respectively.20-25kcal/kg/Bw+20% extra,25-30kcal/kg/Bw+20%extra,30-35kcal/kg/Bw+20%extra,35-40kcal/kg/bw+20% extra suggested for normal, mild, moderate and severe risk patients respectively. 1.2-1.5/kg/Bw protein were prescribed with nutritional supplements 3 to 10g,10-20g,30-40g,40-60g protein per day for normal, mild ,moderate and severe risk patients respectively. Data were considered statistically significant at p<0.05. We found 2.3%,8.7%,36.3%,36.2% patients were undernourished as per parameters BMI,TSF,MAC,MUAMC respectively. This condition is basic indicator of surgical risk, making nutritional support an important aspect of therapy for patients with chronic end stage liver disease and pre organ liver transplant
Patients with chronic liver disease experience a significant degree of malnutrition which makes nutritional support an important aspect of therapy. Despite the difficulties in assessment, we recommend that a simple , in expensive non invasive techniques such as anthropometric measurements, hand grip strength test,6 minutes walk test are recommended to evaluate the effects , adequacy of nutritional interventions before liver transplantation and nutritional counseling leads to decrease nutritional risk .