Document Detail


Validation of body mass index for the diagnosis of malnutrition in patients with liver cirrhosis.
MedLine Citation:
PMID:  17075467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Simple clinical tools are needed to detect malnutrition in cirrhotic patients. We have validated optimal body mass index (BMI) cut-offs for the diagnosis of malnutrition in accordance with the importance of ascites. METHODS: BMI, mid-arm muscle circumference (MAMC) and triceps skinfold thickness (TST) were measured before paracentesis in study (SP) and validation (VP) populations of 875 and 294 cirrhotic patients, respectively with no ascite (NA), mild (MA), tense ascites (TA) (NA/MA/TA: SP: 327, 270, 278; VP: 111, 69, 114). Preserved nutritional status (SP: 259; VP: 93), malnutrition including severe and moderate malnutrition (SP: 251 and 365; VP: 92 and 109) were defined from MAMC and TST measurements. RESULTS: Optimal BMI cut-off values were 22, 23 and 25 kg/m2 in NA, MA and TA patients, respectively. In the whole SP and VP, sensitivities of these cut-offs were 86.2% and 89.1%, respectively; the corresponding negative predictive values (NPV) for the diagnosis of severe malnutrition were 92.3% and 93.2%; specificities and positive predictive values (PPV) were 87.7% and 89.9%, 92.7% and 93.6%, respectively for the diagnosis of malnutrition. In the entire VP, peripheral oedema did not change sensitivity and NPV of BMI cut-offs for the diagnosis of severe malnutrition and tended to increase specificity and PPV for the diagnosis of malnutrition. 96.7% of the malnourished TA patients in the VP before paracentesis were correctly identified after removal of ascites. CONCLUSION: BMI is a reliable parameter to detect malnutrition in cirrhotic patients with the above mentioned cut-offs. Peripheral oedema and removal of ascites do not affect its diagnostic performance.
Authors:
Bernard Campillo; Jean-Philippe Richardet; Phuong-Nhi Bories
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Gastroentérologie clinique et biologique     Volume:  30     ISSN:  0399-8320     ISO Abbreviation:  Gastroenterol. Clin. Biol.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-31     Completed Date:  2007-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704825     Medline TA:  Gastroenterol Clin Biol     Country:  France    
Other Details:
Languages:  eng     Pagination:  1137-43     Citation Subset:  IM    
Affiliation:
Service de Rééducation Digestive, Hôpital Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil. bernard.campillo@ach.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Analysis of Variance
Ascites / etiology,  therapy
Body Mass Index*
Data Interpretation, Statistical
Edema / etiology
Female
Humans
Length of Stay
Liver Cirrhosis / complications*,  mortality
Male
Malnutrition / diagnosis*,  etiology
Middle Aged
Nutrition Assessment
Nutritional Status
Paracentesis
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Skinfold Thickness
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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