A176 IMPROVEMENT IN NUTRITION STATUS IS ASSOCIATED WITH LOWER RATES OF INFECTION AND HEPATIC ENCEPHALOPATHY: A PROSPECTIVE COHORT STUDY

Malnutrition is highly prevalent in cirrhosis and an independent predictor of negative clinical outcomes such as hospitalizations, infections, hepatic encephalopathy (HE), GI bleeding and mortality. Ambulatory nutrition interventions in cirrhosis and their effects on clinical outcomes have been under-explored. The study aim was to identify if a personalized nutrition intervention in malnourished pre-transplant patients with cirrhosis impacted clinical outcomes at 6–12 months. A prospective cohort study was conducted from 2014–2017 at the University of Calgary malnutrition clinic. Participants were assessed by a registered dietitian and a physician nutrition specialist and completed measurement of subjective global assessment (SGA), handgrip strength (HGS) and mid arm circumference (MAC). Patients identified as malnourished received tailored nutrition intervention. Clinical outcomes on frequency of hospitalizations, infections, HE and mortality were collected 6–12 months following intervention. T-tests, chi-squared analyses and analysis of covariance (ANCOVA) were used to examine relationships between nutrition assessment measures and outcomes. This study included 43 patients and 53.1%(n=25) were male. Compared to baseline, at 6–12 months there was a significant increase in BMI, improvements in HGS and MAC category, and more patients in a lower MELD-Na category, reflecting less severe disease (Table 1). Clinically, SGA classification improved, but this did not reach statistical significance. Patients whose SGA improved had a greater improvement in MELD-Na compared to those whose SGA worsened or was maintained (F(2)=6.95, p<0.05). Worsening SGA at follow up was associated with increased infections and HE (Chi2(1) =7.93, p<0.01; Chi2(2) =5.82, p=0.05, respectively). Fewer hospitalizations were potentially observed in patients with improved SGA status (p=0.11) and MAC (p=0.13), but this was not statistically significant. No other associations were found between HGS or MAC changes and clinical outcomes at follow-up compared to baseline. Improvement in SGA status appears to be associated with fewer infections and lower frequency of HE at 6–12 months. Nutrition assessment and intervention may benefit clinical outcomes in patients with cirrhosis. Table 1. Characteristics at baseline and 6–12 month follow up None

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