HAND GRIP STRENGTH AS A NUTRITIONAL ASSESSMENT TOOL IN PATIENTS WITH LIVER CIRRHOSIS.

Background: -Protein energy malnutrition (PEM) is a recognized complication in patients with liver cirrhosis; most randomized studies have shown a significant increase in morbidity and mortality in relation to its severity. Yet, there is no gold standard method for nutritional assessment of these patients up till now. Aim of the work: - the aim of this study is to assess the efficacy of hand grip strength as a nutritional assessment tool and its sensitivity and specificity in detecting PEM. Methods: -This is a case control study that was designed to analyze data from 78 Egyptian patients with CHILD C liver cirrhosis. Subjective global assessment (SGA), anthropometric tools, hand grip strength (HGS) were used to assess the nutritional status of these patients. It also included 50 healthy volunteers with matched age, gender and area of residence. Results: - Severe PEM was prevalent among the patients; HGS was highly correlated to the degree of malnutrition (p-value = 0.008). ROC curve analysis showed a criterion of 17.6 with specificity 90% and sensitivity of 60 %. Conclusion:- PEM is prevalent among patients with cirrhosis. Nutritional assessment in decompensated patients remains a challenge for clinicians. HGS is a simple, bed side tool that can be used to assess the muscle status and can be used in a complementary manner with other methods for proper assessment of the patients.