Nutritional Status Trajectory in Decompensated Chronic Liver Disease: A Prospective Survey of Pre- and Post-Hospitalization Changes Using Comprehensive Anthropometric, Biochemical, Clinical, Dietary and Handgrip Strength Assessments

Abstract

Malnutrition in decompensated chronic liver disease leads to hepatic encephalopathy, sepsis and sarcopenia, and remains a key predictor of poor survival. This study evaluates and compares the overall health status of DCLD patients pre- and post-hospitalization following medical treatment and dietary modification. Nutritional status was assessed using anthropometric, biochemical, clinical, dietary and handgrip strength assessments. A total sample of 10 patients (n=10) diagnosed with DCLD were placed on a salt-restricted high-protein diet with oral nutritional supplements (ONS) and late evening snacks. Post-hospitalization assessment reveals 60% nutritional improvement witnessed with reduced ascites, improved intake, enhanced handgrip strength, and significant electrolyte balance. Lower serum albumin levels in all samples indicate poor baseline health status, which is associated with ascites. Hyponatremia and hypoalbuminemia were noted in 80% of samples at admission, and changes in hyponatremia were noted in 60% of samples as sodium values improved at the time of discharge, with resolution observed in 20% of samples. Dietary assessment shows 60% of samples achieved the actual nutrition requirement while the remaining 40% had inadequate intake due to disease severity. Handgrip strength was monitored at the first and last day of hospitalization. As the hospital stay ranged from 4 to 7 days, improvement in handgrip strength was gradually noted in 70% of samples, while the remaining were unchanged. This proves that right diagnosis with proper therapeutic nutritional care helps in optimizing health status.