A179 EXPLORING RELATIONSHIPS BETWEEN HANDGRIP STRENGTH, MID-UPPER ARM CIRCUMFERENCE, SUBJECTIVE GLOBAL ASSESSMENT AND ADVERSE CLINICAL OUTCOMES IN CIRRHOSIS: A PROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Malnutrition is highly prevalent in cirrhosis and is an independent predictor of negative clinical outcomes. Nutrition assessment (NA) is often not performed in patients with cirrhosis and this may result from a lack of clarity surrounding valid bedside tools. The study aimed to identify relationships between baseline NA measurements and adverse clinical outcomes in patients with cirrhosis. A prospective cohort study was conducted between 2014–2018 at the University of Calgary. Ambulatory pre-liver transplant patients with cirrhosis were co-assessed by a registered dietitian and a physician nutrition specialist in a specialized malnutrition clinic, and completed measurements of subjective global assessment (SGA), handgrip strength (HGS) and mid upper arm circumference (MUAC). Clinical outcomes including frequency of hospitalizations, length of stay, infections, and hepatic encephalopathy were collected in the 6–12 months following nutrition assessment. Mortality was examined from baseline to 3 years. T-tests and chi-squared analyses were used to examine relationships between NA tools and clinical outcomes. This study included 66 patients, mean age 54 (±10.1) years, and 56% (n=37) male. Baseline demographic characteristics are summarized in Table 1. Malnourished SGA status (9.5% (n=2) SGA A vs. 90.5% (n=19) who were SGA B and C) and lower HGS category (23.8% (n=5) who had a higher HGS vs. 76.2% (n=16) with a lower HGS) both had significantly higher proportions of mortality (SGA: (χ2(2)=6.6, p<0.05); HGS: (χ2(1)= 15.9, p<0.001), while MUAC was not significantly related to mortality (χ2(1) =1.9, p=0.17). The probability of a mortality event was 3.2 times more likely when they were in a lower HGS category. Higher MELD category was also associated with increased mortality (χ2(1) =4.1, p=0.04). SGA, HGS and MUAC were not significantly related to the other clinical outcomes. In our study, malnutrition diagnosed by both SGA and HGS is predictive of mortality in cirrhosis. Incorporating SGA and HGS into routine clinical practice for pre-liver transplant patients with cirrhosis to identify patients who may benefit form nutrition therapy should be considered. Demographic and Health Characteristics Baxter Canada
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".