Assessment of Malnutrition, Sarcopenia and Frailty in Patients with Cirrhosis: Which Tools Should We Use in Clinical Practice?
2020
Buchard, Benjamin | Boirie, Yves | Cassagnes, Lucie | Lamblin, Géraldine | Coilly, A. | Abergel, Armando | CHU Clermont-Ferrand | Unité de Nutrition Humaine (UNH) ; Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Institut Pascal (IP) ; SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS) | Physiopathogénèse et Traitement des Maladies du Foie (HEPAREG) ; Hôpital Paul Brousse-Université Paris-Saclay | Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Hôpi
This article belongs to the Special Issue Nutrition in Liver Cirrhosis and Liver Transplantation
Mostrar más [+] Menos [-]Inglés. Malnutrition is a common comorbidity in patients with cirrhosis. Its prognostic value is indisputable as it greatly affects the evolution of liver diseases. It has a major impact on both morbi-mortality before and after liver transplantation. Being now integrated in the definition of malnutrition and recognized as a new entity in the international classification of diseases, physicians have taken great interest in sarcopenia. Its negative consequences on the fate of patients with cirrhosis are well-demonstrated. The concept of frailty has recently been enlarged to chronic liver diseases as symptoms of impaired global physical functioning. In this article, we will discuss the definitions of malnutrition and emphasize its links with sarcopenia and frailty. We will show the relevance of frailty and sarcopenia in the course of liver diseases. The emerging role of muscle depletion on the cardiorespiratory system will also be highlighted. The importance of body composition will be demonstrated and the main tools reviewed. Finally, we adapted the definition of malnutrition to patients with cirrhosis based on the assessment of sarcopenia together with reduced food intakes.
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