2024/12/27 by Stuart Bartlett, Tsz Hong Yiu, Zina Valaydon
Medicine · Nursing · #Clinical Nutrition and Gastroenterology #Liver Disease Diagnosis and Treatment #Nutrition and Health in Aging
paper · doi:10.1016/j.nut.2024.112675
openalex publication_date 2024/12/27 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31
• Malnutrition in Liver Cirrhosis is common but under-diagnosed. • Malnutrition is associated with increased rates of liver-related complications and overall mortality. • There are currently no consensus guidelines for the assessment of malnutrition in liver cirrhosis. • We recommend the use of the Royal Free Hospital-Nutritional Prioritizing Tool alongside anthropometric measurements and body composition assessments to ensure a comprehensive nutritional assessment. Malnutrition is common in liver cirrhosis and is associated with increased rates of complications, hospitalization, and mortality. There are no consensus guidelines for malnutrition assessment in liver cirrhosis and a large number of clinicians do not routinely assess for malnutrition in patients with liver cirrhosis. This review explores the tools available for assessment of malnutrition in patients with liver cirrhosis, including nutritional screening protocols, anthropometric tools, biochemical tools, techniques analyzing body composition and functional assessments. We evaluate these tools and offer recommendations regarding their suitability for outpatient settings. In this review, we recommend the Royal Free Hospital-Nutritional Prioritising Tool for identifying patients at risk of malnutrition. Additionally, we recommend the use of the anthropometric tools Triceps Skinfold Thickness for females and Mid-Arm Muscle Circumference for males, due to differing patterns of muscle and fat malnutrition. Complementing this Bioelectrical Impedance Analysis can be utilized to assess body composition for the diagnosis of malnutrition. Biochemical markers have thus far failed to show a correlation with malnutrition. While hand grip strength is useful for detecting sarcopenia, a common complication of malnutrition, further evidence is required to validate its correlation with malnutrition.