| Object:Assess the nutritional risk of inpatients with chronic liver disease,to explore the influencing factors of nutritional risk in patients with chronic liver disease,and analyze the role of the third lumbar spine(L3)psoas muscle index of inpatients with chronic liver disease in nutritional evaluation of liver disease.Methods:A retrospective study method was used to collect chronic liver disease patients who met the inclusion and exclusion criteria in the Department of Hepatology of the First Hospital of Jilin University from January 2018 to September 2019,and consulted the medical record system to organize relevant data for research analysis.The general clinical data and nutrition-related laboratory test indicators of patients were compared and analyzed according to different subgroups(cause,liver function classification,age,complications),and the trends of each indicator were observed.L3 psoas muscle index was measured using a CT image of the patient's whole abdomen,and compared and analyzed with the traditional nutrition evaluation method NRS2002 score,body mass index(BMI)and laboratory test indicators.Patients were divided into nutritional risk groups(?3 points)and non-nutritional risk groups(<3 points)according to the NRS2002 scoring criteria.The clinical data and laboratory test results of the two groups were compared for differences.Correlation analysis of NRS2002 score,psoas muscle index and other indicators,single factor analysis of related factors of nutritional risk,multi-factor logistic regression analysis if eligible,and finally diagnostic value analysis of different indicators of nutritional risk.Results:A total of 502 patients were included,329 males and 173 females,aged 17-92 years,with an average age of 57.55 ± 11.65 years.The overall risk ratio for nutrition was 53.6%.Among the nutrition risk group,146 were male(44.4%).There were 123 females(71.1%)with an average age of 60.39 ± 11.55 years;in the non-nutrition risk group,183 males(55.6%)and 50 females(28.9%)with an average age of 54.26 ± 10.89 years.Compared with the nutritional risk group and the non-nutritive risk group,the differences in gender and age of the patients were statistically significant(P <0.05).The BMI of patients with nutritional risk group was smaller than that of non-nutritive risk group [22.39(4.33)kg / m~2 vs.23.90(4.01)kg / m~2],the difference was statistically significant(P <0.05).The psoas muscle index of the nutritional risk group and the non-nutrition risk group were 404.67(210.99)mm~2/ m~2and 661.38(225.2)mm~2 / m~2.The psoas muscle index of the nutritional risk group was significantly lower than that of the non-nutritive risk group.It has statistical significance(P <0.05).As patients' liver function reserve decreases and their age increases,the NRS2002 score tends to increase,suggesting that patients are more likely to develop nutritional risks.The group with ascites,liver cancer,and hepatic encephalopathy-related complications was compared with the group without NRS2002 scores were higher,and the difference between the two groups was statistically significant(P <0.05).Logistic regression analysis of the influencing factors of nutritional risk showed that the lower the psoas major index,the higher the possibility of patients' nutritional risk(OR = 0.992,95% CI: 0.990-0.993).The receiver operating characteristic curve(ROC curve)was used to compare the diagnostic value of the psoas muscle index and other nutritional indicators.The area under the psoas muscle index was 0.835,which has a better diagnostic effect than other traditional indicators.Conclusions:Inpatients with chronic liver disease have a higher proportion of nutritional risk,and psoas muscle index is related to patients' nutritional risk.The higher the psoas muscle index,the lower the risk of nutrition probability.Among the various nutrition assessment methods,psoas muscle index has a better diagnostic effect.The psoas muscle index can be used as an independent predictor of nutritional risk in patients. |
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