Nutritional Assessment of Nonhospitalized Patients with Liver Cirrhosis in 04 Reference Hospitals in Cameroon

Abstract Introduction: Protein-energy malnutrition is a common complication in cirrhosis. It is a factor of morbidity and mortality in cirrhotic patients. Our study aimed to determine the prevalence of undernutrition in Cameroonian cirrhotic patients. Methodology: this was an analytical cross-sectional study over 04 months from December 15, 2019, to April 15, 2020. It was framed at 04 reference hospitals in the cities of Douala and Yaoundé. Patients with cirrhosis aged over 18 who agreed to participate in the study were included. The data collected were clinical and paraclinical. Subjective Global Assessment (SGA), triceps skinfold (TSF), and arm muscle circumference (AMC) were used for nutritional assessment. The associated factors were sought by univariate and multivariate analyses. The significance level was set at 0.05. Results Seventy-five patients agreed to participate in our study. The average age was 56+/-15.8 years with extremes ranging from 18 to 80 years. The male gender accounted for 52% (N = 39) of the patients, i.e. a sex ratio of 1.08. The most common etiologies were viral hepatitis B in 50.67% (N = 38) and viral hepatitis C in 48% (N = 36). The most frequent clinical signs were early satiety (N = 47), ascitis (N = 40), anorexia (N = 37). The mean albumin value was 32.2±8.2g/l. The Child-Pugh score was classified as C in 21.3% (N = 16). The prevalence of malnutrition was 46.6% (N = 35), 60% (N = 45) and 94.7% (N = 71) according to SGA, AMC and TSF respectively. The factors associated with malnutrition are a Child-pugh C score (p = 0.00; OR 10.21 [95% CI: 1.23–53.91]), recent hospitalization for > 5 days (p = 0.03 OR 10.1 [95% CI: 2.7-110.6]), anorexia (p = 0.00; OR 4.3 [95% CI: 2-11.8]), the presence of ascites (p = 0.003; OR 20.7 [95% CI: 5.8–101.2]), hypoalbuminemia (p = 0.00; OR 3.3 [95% CI: 0.9–73] and serum creatinine greater than 12mg/l (p = 0.00; OR 4.5 [95% CI: 1.3–10.3]). Conclusion The prevalence of malnutrition during cirrhosis was 46.6%, 60%, and 94.7% respectively according to SGA, arm muscle circumference (AMC), and triceps skinfold (TSF). The factors associated with malnutrition are recent hospitalization (> 5 days), anorexia, the presence of ascites, the Child-Pugh C score, hypoalbuminemia, and high creatinine.