Mini Nutritional Assessment ‐ Short Form Is a Useful Malnutrition Screening Tool in Patients with Liver Cirrhosis, Using the Global Leadership Initiative for Malnutrition Criteria as the Gold Standard

• Published in: Nutrition in clinical practice 2021-10, Vol.36 (5), p.1003-1010
• Main Authors: Casas Deza, Diego, Betoré Glaria, María Elena, Sanz‐París, Alejandro, Lafuente Blasco, Miguel, Fernández Bonilla, Eva María, Bernal Monterde, Vanesa, Arbonés Mainar, José Miguel, Fuentes Olmo, Javier
• Format: Article
• Language: English
• Subjects: liver cirrhosis; malnutrition; Nursing; nutrition assessment; nutrition screening
• ISSN: 0884-5336; 1941-2452
• DOI: 10.1002/ncp.10640

Background The use of nutrition‐screening tools in cirrhotic patients is not systematized. Recently, specific tools have been proposed for patients with cirrhosis, but their diagnostic capabilities have been scarcely studied. Methods This was a prospective study that includes outpatients with liver cirrhosis undergoing follow‐up in the hepatology consultations of a tertiary‐care university hospital. A trained gastroenterologist applied the screening tools: Liver Disease Universal Screening Tool (LDUST), Royal Free Hospital‐Nutrition Prioritizing Tool (RFH‐NPT), and Mini Nutritional Assessment‐Short Form (MNA‐SF). Subsequently, the diagnosis of malnutrition was made according to Global Leadership Initiative for Malnutrition (GLIM) criteria by an endocrinologist, who was blind to the results of the screening tools. Results Sixty‐three patients (38.1% women, mean age 63.1 ± 9.9 years) with cirrhosis (60.3% Child‐Pugh A, 34.9% Child‐Pugh B, and 4.8% Child‐Pugh C) were evaluated. The prevalence of malnutrition was 38.1% (15.9% moderate, 22.2% severe). Advanced stages of cirrhosis were associated with a higher prevalence of malnutrition (P = .021). MNA‐SF was the most accurate screening tool, being superior to RFH‐NPT and LDUST. It presented better sensitivity than RFH‐NPT (88% [0.68–0.97] vs 67% [0.45–0.84], P = .031) and better specificity than both LDUST (97% [0.87–0.99] vs 62% [0.45–0.77], P < .001) and RFH‐NPT (97% [0.87–0.99] vs 82% [0.67–0.93], P = .016). Conclusions According to the GLIM criteria, malnutrition affected 38.1% of patients with cirrhosis, being severe in 22% of the patients. MNA‐SF is the most accurate screening test, superior even to tools specifically designed for cirrhotic patients (LDUST).