Preoperative nutritional evaluation of patients with hepatic alveolar echinococcosis

OBJECTIVE: This study is aimed at determining the preoperative nutritional status of patients with hepatic alveolar echinococcosis (HAE), and subsequently establish a concise and reasonable nutritional evaluation indicator. The established evaluation method could be used for clinical preoperative risk assessment and prediction of post-operation recovery. METHODS: The basic patient information on height, body weight, BMI and hepatic encephalopathy of 93 HAE patients were examined. Subsequently, abdominal ultrasonography, blood coagulation and liver function tests were done on the patients. Liver function was assessed using the Child-Pugh improved grading method while nutritional status was evaluated using the European Nutrition Risk Screening 2002 (NRS 2002) method. Additional parameters including hospitalization time, the hemoglobin (HGB) level on the 3(rd) day after the operation, and the number of postoperative complications of HAE patients were also recorded. RESULTS: The NRS 2002 score was negatively correlated with body weight, body mass index (BMI)and albumin (ALB) (P<0.01), and positively correlated with the transverse and longitudinal diameters of the lesions (P<0.01). A worse grading of liver function was associated with a low ALB and a high NRS 2002 score (P<0.01). Results of the NRS 2002 score indicate that the hospitalization time of the normal nutrition group was significantly shorter than that of the malnourished group (P < 0.05). The HGB level of the control group on the 3(rd) day after the operation was significantly higher than that of the malnourished group (P < 0.05), and the number of postoperative complications was lower than that of malnutrition group (P < 0.05). CONCLUSION: Malnutrition is common in HAE patients. The nutritional status of HAE patients is related to many clinical factors, such as Child-Pugh classification of liver function, size of the lesion, and ALB among others. Although both BMI and ALB can be used as primary screening indicators for malnutrition in HAE patients, NRS 2002 is more reliable and prudent in judging malnutrition in HAE patients. Therefore, BMI and ALB are more suitable for preoperative risk assessment and prediction of postoperative recovery.