Case Reports in Surgery and Invasive Procedures

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Case Reports in Surgery and Invasive Procedures 44 7897 074717

Protein Calorie Malnutrition Open Access Articles

Protein–energy malnutrition (PEM) in chronic liver disease has been well documented with a prevalence of 27–100%. The severity of PEM is dependent on etiology and length of disease, with alcoholic liver disease patients being worst effected.PEM in chronic liver disease has been demonstrated as an independent risk factor to clinical outcome and, therefore, is always prioritized in the treatment of cirrhotic patients. Protein energy malnutrition has been associated with:

Worsening encephalopathy;

Poor control of ascites;

Increased infection rate;

Increased hospital admissions;

Increased mortality.

PEM is exacerbated in cirrhotic patients by accompanying anorexia and malabsorption. The latter may be affected by ascites and/or edema, and does not differentiate between fat and muscle stores. Normal weight or obesity may mask PEM, as normal or excessive fat stores can be present in such patients. The patient's requirements will need to be calculated and met, orally, nasoenterally or intravenously.

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