Comparison of hand grip, subjective global assessment and anthropometric measurements in evaluation of enteral nutrition effectiveness in cirrhosis patients with malnutrition

AIM: A number of assessment methods are recommended to evaluate malnutrition in patients with cirrhosis. In this thesis, we aimed to investigate how compatible anthropometric measurements, subjective global assessment and hand grip tests are in showing the change in nutritional status in patients with cirrhosis who were started on oral supplementation due to malnutrition. MATERIALS AND METHODS: Patients diagnosed with cirrhosis who admitted the gastroenterology outpatient clinic between June 2022 and December were evaluated. Malnutrition status was determined according to NRS-2002, RFH-NPT or SGA tests and food consumption records were taken. Nutritional product was given as 35 kcal/kg/day caloric intake. BMI, hang grip (HG), triceps skinfold thickness (TST), subscapular skinfold thickness (SST), upper middle arm circumference (MAC) measurements were recorded at the beginning and after 8 weeks of treatment. Posttreatment nutritional risk scores were also reassessed, and data at baseline and eight weeks were analyzed. RESULTS: In our study, of 30 patients with malnutrition diagnosed with cirrhosis were 14 (46.7%) women and 16 (53.3%) men. The age range of the patients was 42.0- 87.0, the mean age was 65.0±12.1. According to SGA, 13.3% of the patients were severely malnourished, 36.7% moderately malnourished, and 46.7% mildly malnourished. Post-treatment NRS-2002, RPH-NPT and SGA scores showed a significant (p < 0.05) decrease compared to pre-treatment. Post-treatment HG, TST measurements showed a significant (p < 0.05) increase compared to pre-treatment. There was good agreement between SGA and RFH-NPT in the post-treatment and post-treatment change (respectively; Kappa: 0.879/ p=0.000, τb=0.856/ p=0.000). Post-treatment TST was positively moderate correlated with other MAC and SST. (respectively; r=0.612, r=0.557). There was poor agreement between HG and other anthropometric measurements and nutritional risk scores. CONCLUSION: Among the nutritional assessment tools, SGA and RFH-NPT seem to be the most compatible tools in monitoring the efficacy of treatment. Among anthropometric measurements, TST can be recommended as a compatible tool in early evaluation. Keywords: Hand grip, Liver cirrhosis, Malnutrition, Subjective global assessment