Thématique :
- Foie
Originalité :
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
  2017 Mar;65(3):1044-1057  
  doi: 10.1002/hep.29003.  
  A practical approach to nutritional screening and assessment in cirrhosis.  
  Tandon P, Raman M, Mourtzakis M, Merli M  


Malnutrition is one of the most common complications of cirrhosis, associated with an increased risk of morbidity and mortality. As a potentially modifiable condition, it is of particular importance to identify malnourished patients so that nutritional therapy can be instituted. Nutrition screening and assessment are infrequently performed in patients with cirrhosis. The reasons for this are multifactorial, including the absence of a validated "rapid" screening tool, multiple definitions of what constitutes malnutrition, and challenges with interpreting body composition and laboratory results in the setting of volume overload and liver dysfunction. This article summarizes the clinically relevant evidence and presents key issues, tools, and clinical options that are applicable to patients with cirrhosis. The definition, etiology, and clinically relevant outcomes associated with malnutrition are reviewed. Rapid nutritional screening is differentiated from more detailed nutritional assessment. Nutritional assessment in special populations, including women and the obese, and the role of inflammation are discussed. Multicenter studies using a common nutritional screening/assessment strategy are the next steps to fast-track adoption and implementation of nutrition-related evaluations into routine clinical practice. (Hepatology 2017;65:1044-1057).

Question posée
Revue sur la dénutrition chez les patients cirrhotiques : définition, étiologie et mécanismes, mise en évidence, évaluation dans des cas particuliers.
Question posée

Excellente revue sur la mise en évidence de la dénutrition du cirrhotique et ses mécanismes à bien connaître pour mettre en œuvre des outils pour améliorer ce statut nutritionnel.