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Comprehensive nutritional management incorporating home-based dietary consultation improves hepatic encephalopathy in cirrhotic patients: a retrospective cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: Few studies have clinically demonstrated the benefits of comprehensive nutritional management incorporating home-based dietary consultation in patients with cirrhosis. This study investigates whether such management can improve the prognosis of cirrhotic patients. METHODS: This retrospective study included 260 cirrhosis patients hospitalized between May 2022 and August 2023. We compared baseline characteristics and adverse outcomes during follow-up between patients who received comprehensive nutritional management incorporating home-based dietary consultation (nutritional management group) and those who did not (usual care group). Kaplan-Meire analysis was applied to compare the liver transplant-free survival rate and the cumulative overt hepatic encephalopathy (OHE)-free rate between groups. Univariate and multivariate Cox regression models were performed to identify clinical factors associated with prognosis. RESULTS: The incidence of OHE was significantly lower in the comprehensive nutritional management group compared to the usual care group. Kaplan–Meier analysis demonstrated a considerably higher cumulative OHE-free rate in the nutritional management group (log-rank P = 0.001). However, the two groups had no significant difference in liver transplant-free survival. Multivariate Cox regression analysis identified nutritional management (HR 0.326, 95% CI: 0.150–0.712, P = 0.005) and higher serum albumin levels (HR 0.917, 95% CI: 0.855–0.983, P = 0.015) as protective factors against OHE, whereas sarcopenia (HR 2.541, 95% CI: 1.297–4.977, P = 0.007) and elevated serum ammonia levels (HR 1.009, 95% CI: 1.000–1.018, P = 0.043) were associated with increased risk. However, comprehensive nutritional management was not significantly associated with mortality in Cox multivariate analysis. CONCLUSIONS: Implementing comprehensive nutritional management incorporating home-based dietary consultation is beneficial in reducing the risk of OHE in cirrhosis patients.

Source: BMC Gastroenterology

DOI: 10.1186/s12876-025-04520-8