الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 92 |  |  |
| | | from | 92 | | |
Abstract
The need for nutritional assessment tool is essential especially postoperative in a highly vulnerable population like hepatic patients who are more susceptible than other for malnutrition which also can aggravate their primary pathology as chronic liver disease.
The need for a new technique which is easier, less hazardous, noninvasive, accurate is a challenge.
This is a prospective observational study with local Ethics Committee approval and patient consents. 78 patients (6 excluded) were enrolled in the study ,followed in POD0,1,3,5&7 ,anthropometry measurements ,weight ,height, BMI, modified BMI,MAC, TSF, HGS. Laboratory data, total protein, albumin, transferritin, BUN, phosphate. Ultrasonography on RF & AT muscles data CSA, AP diameter, LL diameter, echogenicity according to Heckmatt scale. ICU & hospital stay.
Patients’ demographic data were described, median of age was 51.5 with IQR 45.00-56.00, 39 patients (54.2%) were male & 33 patients (45.8%) were female. 62 patients (86.1%) were child score A & 10 patients (13.9%) were child score B. 52 patients (72.2%) were SGA A & 20 patients (17.8%) were SGA B. 25% of patients underwent resection. Intensive care unit stay, median was 3.00 & IQR was 2.00 to 4, 50. Hospital stay, median was 7& IQR was 5.00 to 10.00. The weight was significantly increased in POD1, 3and 5 compared to POD0 while it was decreased in POD7 compared to POD1, 3and 5. The BMI was significantly increased in POD1, 3and 5 compared to POD0 while it was decreased in POD7 compared to POD1, 3 and 5.The modified BMI was significantly decreased in POD1, 3, 5and 7 compared to POD0. While it was increased in POD5 and 7 compared to POD1and 3. Regards MAC there was overall significance between all readings. About TSF, It was significantly increased in POD5&7 compared to POD0. The HGS was significantly decreased in POD1,3,5and 7 compared to POD0, while it was significantly increased in POD3,5&7 compared to POD1 and significantly increased in POD7 compared to
Summary
66
POD3&5. The serum protein was significantly decreased in POD1, 3, 5and 7 compared to POD0. While it was significantly increased in POD5&7 compared to POD1 and it was significantly increased in POD7 compared to POD3&5. Albumin was significantly decreased in POD1, 3, 5 and 7 compared to POD0. While it was significantly increased in POD5&7 compared to POD1&3 and it was significantly increased in POD7 compared to POD5. The transferritin was significantly decreased in POD1, 3, 5 and 7 compared to POD0. And it was also significantly decreased in POD3, 5&7 compared to POD1 and significantly decreased in POD7 compared to POD3. Blood urea nitrogen BUN was significantly lower in POD7 compared to POD1.
Regarding phosphate, it was significantly decreased in POD3, 5 compared to POD0 also it was significantly decreased in POD3 compared to POD1 and it was significantly increased in POD7 compared to POD3.
Quantitative parameters of RF muscle: CSA, AP and LL diameters were significantly decreased in POD3, 5 and 7 compared to POD0 &1 and also significantly decreased in POD5&7 compared to POD1
Qualitative parameter of RF muscle: Echogenicity was significantly decreased in POD3, 5&7 compared to POD0 and also significantly decreased in POD5&7 compared to POD3
Quantitative parameters of AT muscle: CSA, AP & LL diameters were significantly decreased in POD3, 5&7 compared to POD0&1 and also significantly decreased in POD5&7 compared to POD1.
Qualitative parameter of AT muscle: Echogenicity was significantly decreased in POD3, 5&7 compared to POD0&1 and also significantly decreased in POD7 compared to POD3.
Percentage of loss for RF muscle: There was 0.56% loss of CSA at POD1. 2.05 % loss at POD3, 3.28% loss at POD5, 3, 67% loss at POD7.
Summary
67
For AT muscle: There was 0.23 % loss of CSA at POD1. 1.03 % loss at POD3, 1.84% loss at POD5, 2.49% loss at POD7.
For both muscles, there was no statistically significance difference between group A SGA & group B SGA about percentage of muscle wasting estimated by CSA.
In conclusion; ultrasonography was able to detect quantitative and qualitative parameter of RF and AT muscles. More future studies on ultrasonography in depth and among wider population undergoing different surgeries is still needed to evaluate its accuracy and reliability as a nutritional assessment tool.