Nutritional consultation boosts nutritional status in patients with alcohol-associated hepatitis

Protein-calorie malnutrition is prevalent in patients with alcohol liver disease, impacting disease progression and morbidity. A recent retrospective study found that nutritional support led to significant improvements in meal consumption and nutritional intake in patients with alcohol-associated hepatitis (AAH).

The study included 206 patients with alcoholic steatohepatitis or cirrhosis who had been admitted for AAH. Patients were divided into 2 groups based on whether they received inpatient nutritional consultation upon admission. Primary endpoints included hospital length of stay, incidence of decompensation, and changes in nutritional status. Secondary endpoints included 28-day mortality rates and overall meal consumption. Findings were presented by Dr Nariman Hossein-Javaheri (University at Buffalo, NY, USA) [1].

Among the studied patients, 47% received nutritional consultations. These patients had a higher prevalence of cirrhosis (49.5% vs 30.3%; P<0.01), a longer length of stay (9.4 vs 6.6 days; P<0.001), and a higher Model for End-Stage Liver Disease (MELD) score (12.1 vs 9.6; P<0.001). The nutritional status showed lower albumin (3.5 vs 4.2 g/dL; P<0.01) and pre-albumin (11.1 vs 16.6 mg/dL; P=0.02) levels, and a lower BMI (26.3 vs 28.0 kg/m²; P=0.02). Additionally, those receiving nutritional consultation had a higher incidence of ascites (18.5% vs 6.8%; P<0.001), but not of gastrointestinal bleeding (11.3% vs 10.1%; P=0.4), and a lower incidence of encephalopathy (17.4% vs 33.1%; P<0.001).

Nutritional consultation significantly increased total caloric intake by 23.5% (P<0.001) and additional protein intake by 30.6 g. However, the 28-day mortality rate was not significantly different between the 2 groups (7.2% vs 3.7%; P=0.13).

“Patients who received nutritional consultation were generally sicker, with higher MELD scores and greater prevalence of cirrhosis. Despite this, nutritional support led to significant improvements in meal consumption and nutritional intake, highlighting the importance of early dietary consultation in managing AAH,” concluded Dr Hossein-Javaheri.

1. 
   
   1. Hossein-Javaheri N, et al. Nutritional consultation improves protein and total caloric intake in patients admitted with alcohol-associated hepatitis. 686, DDW 2024, 18–21 May, Washington, DC, USA.

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Posted on 11 July 202411 July 2024