Nutritional Risk Assessed by Royal Free Hospital-Nutritional Prioritizing Tool Predicts Survival in Cirrhosis With or Without Hepatocellular Carcinoma.

BACKGROUND

Nutritional status is an independent factor that affects clinical outcomes in patients with liver cirrhosis (LC). This study aimed to investigate the prognosis of patients with LC according to their nutritional risk.

METHODS

From January 2020 to April 2021, the medical records of patients with LC with/without hepatocellular carcinoma (HCC) who underwent abdominal computed tomography and nutritional risk evaluation using the Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) were retrospectively reviewed.

RESULTS

In total, 243 patients were analyzed, 92: LC without HCC and 151: LC with HCC. Nutritional risk analysis using RFH-NPT revealed that 121 (49.8%) patients were low-risk, 35 (14.4%) moderate-risk, and 87 (35.8%) high-risk. Child-Pugh class (P < 0.001), albumin-bilirubin score (P < 0.001), and psoas muscle index (P < 0.001) significantly correlated with nutritional risk in all patients. Serum sodium levels were significantly different based on the nutritional risk in LC without HCC (P = 0.008) and with HCC (P = 0.001). Total cholesterol levels were significantly correlated with nutritional risk in all patients (P < 0.001) and in patients with LC with HCC (P < 0.001). Survival rates differed significantly according to nutritional risk in all patients (P < 0.001), patients with LC without HCC (P = 0.017), and patients with LC with HCC (P < 0.001). RFH-NPT high risk (hazard ratio [HR], 3.115; 95% confidence interval [CI], 1.396-6.950; P = 0.006), Child-Pugh C (HR, 12.802; 95% CI, 5.062-32.372; P < 0.001) and HCC (HR, 9.078; 95% CI, 3.657-22.535; P < 0.001) were significant factors affecting the survival rate of all patients.

CONCLUSION

RFH-NPT is a useful method for evaluating nutritional risk and predicting the survival rate of patients with LC with/without HCC.