Determinants of malnutrition in chronic liver disease patients in Hospital Selayang using royal free hospital nutritional prioritizing tool (RFH-NPT)

Malnutrition has become a common problem that is associated with chronic liver disease (CLD), with a prevalence of 50 - 90%, and correlated with an increased risk of mortality and morbidity among CLD patients. This study aimed to investigate the determinants of malnutrition among CLD patients. This study involved 85 CLD patients at Hospital Selayang. The nutritional status of the participants was obtained by anthropometric measurements, including weight, height, body mass index, mid- upper arm circumference, and skinfold thickness (tricep skinfold thickness, chest skinfold thickness, and subscapular skinfold thickness). The biochemical findings of albumin, total bilirubin, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase were obtained from medical records. Nutrition screening using RFH-NPT and food/nutrition-related history were determined. Meanwhile, the health-related quality of life (HRQoL) data was obtained using the Short Form 36 (SF-36). All data obtained from this study were analysed using Statistical Package for the Social Sciences (SPSS) version 29: descriptive statistics, Chi-square test or Fisher-Freeman-Halton Exact test, and ordinal logistic regression. CLD patients had low means of calorie and protein intake, 15.26 ± 5.71 kcal/kg/day, and 0.64 ± 0.29 g/kg/day, respectively. They reported a low HRQoL, with a decrease in most HRQoL components except for role limitations due to emotional problems, emotional well- being, social functioning, and body pain. There was also a significant association between anthropometric data and HRQoL with the risk of malnutrition. Multivariate analysis highlighted that calorie intake (OR = 25.336, 95% CI: 1.426, 450.281, p = 0.028), ascites (OR = 0.076, 95% CI: 0.013, 0.440, p = 0.004), and role of limitations due to emotional problems (OR = 0.114, 95% CI: 0.025, 0.509, p = 0.004) were independent risk factors of malnutrition risk. In conclusion, the findings obtained will assist healthcare providers in determining malnutrition risk among CLD patients.