Avaliação nutricional em pacientes graves

Maicá, Anahi Ottonelli; Schweigert, Ingrid Dalira

doi:10.1590/s0103-507x2008000300012

Cited by 27 publications

(37 citation statements)

References 21 publications

(23 reference statements)

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“…The study frequency of malnutrition was very similar to that found by other Brazilian and foreign studies 16,19,20 , corroborating the statement that along the last four decades, the prevalence of malnutrition has remained high 21 , increasing the length of hospital stay and risk of death 22 .…”

Section: Discussionsupporting

confidence: 88%

Risk factors associated with malnutrition in hospitalized patients

Fragas

Oliveira

2016

Rev. Nutr.

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A B S T R A C T ObjectiveTo identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. MethodsThis cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable) and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. ResultsAmong the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. ConclusionMalnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical. Keywords

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Section: Discussionsupporting

confidence: 88%

Risk factors associated with malnutrition in hospitalized patients

Fragas

Oliveira

2016

Rev. Nutr.

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“…Despite the limitation of albumin as an indicator of nutritional status, a number of studies (6,26) have correlated its decline with the increased incidence of clinical complications, morbidity and mortality. In the present study, the patients with a lower PA exhibited lower serum albumin (Table I) The prognosis indices under study did not correlate between each other (Fig.…”

Section: ¹Mean ± Sd ²Median (Variation)mentioning

confidence: 99%

“…Assessment of nutritional status in critically ill patients is hindered by interference from the acute disease and the therapeutic measures applied, which changes body composition and affects result interpretation (6). In this regard, establishing an early nutritional prognosis is important to monitor the nutritional progress of the patient and identify patients at risk of complications who may benefit from a specific nutritional intervention (7).…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, establishing an early nutritional prognosis is important to monitor the nutritional progress of the patient and identify patients at risk of complications who may benefit from a specific nutritional intervention (7). Moreover, poor nutritional prognosis is associated with greater likelihood of morbidity and mortality (6). Among the nutritional prognosis methods are the Phase Angle (PA) and Onodera's Prognostic Nutritional Index (OPNI).…”

Section: Introductionmentioning

confidence: 99%

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Phase Angle and Onodera’s Prognostic Nutritional Index in critically ill patients

et al. 2016

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ResumenIntroducción: en los últimos años se ha valorado la evaluación de la gravedad y del pronóstico nutricional en pacientes críticos, por ser pará-metros relacionados a la morbimortalidad y porteadores de conductas terapéuticas. Objetivo: verifi car el pronóstico nutricional mediante el Ángulo de Fase (AF) y el Índice de Pronóstico Nutricional de Onodera (OPNI) y su relación con la gravedad, con el tiempo de internación y con la mortalidad de pacientes críticos. Métodos: estudio transversal descriptivo, incluyendo pacientes adultos, internados en Unidad de Terapia Intensiva (UTI). Fueron recabados datos en la historia clínica de los pacientes para cálculo de los indicadores de gravedad (APACHE II, SOFA y SAPS 3), y verifi cación del tiempo de internación y desenlace. Fue realizada la bioimpedancia para cálculo del AF, mediante datos de resistencia y reactancia. Resultados: se incluyeron 35 pacientes, con edad promedio de 55,5 ± 16,7 años, siendo 26% del sexo masculino y 74% del femenino. La tasa de mortalidad encontrada en el estudio (17%) fue semejante a aquella esperada por los indicadores de gravedad APACHE II y SOFA, pero superior a aquella esperada por el SAPS 3. Los valores promedios encontrados para el AF (4,2 ± 1,0) y el OPNI (38,7 ± 8,3) fueron inferiores a los valores de referencia adoptados. Aquellos con AF < 5,1 presentaron signifi cativamente menores valores de reactancia y albumina, mayores valores del APACHE II y del SOFA, y tuvieron mayor tiempo de internación y mortalidad. El AF se correlacionó inversamente con todos los indicadores de gravedad, pero lo contrario fue observado con el OPNI, no habiendo correlación entre estos dos indicadores de pronóstico nutricional. Conclusión: el AF es una herramienta confi able para evaluación del pronóstico nutricional en pacientes críticos. Por el contrario, se necesitan más estudios utilizando el OPNI con este tipo de pacientes. AbstractIntroduction: Assessing severity and nutritional prognosis in critical patients has become increasingly important in recent years, since these parameters are related to morbidity/mortality and used to guide therapeutic options. Objective: Determine nutritional prognosis through the Phase Angle (PA) and Onodera's Prognostic Nutritional Index (OPNI) and its relationship with severity, hospitalization time and mortality of critically ill patients. Methods: Descriptive cross-sectional study, involving adult patients hospitalized in an Intensive Care Unit (ICU). Data were collected from the patients' medical records to calculate severity indicators (APACHE II, SOFA and SAPS 3) and determine the length of hospitalization and outcome. Bioimpedance was conducted to calculate the PA, using resistance and reactance data. Results: A total of 35 patients (26% men and 74% women), with mean age of 55.5 ± 16.7 years, were included. The mortality rate (17%) was similar to that expected by APACHE II and SOFA, but higher than that predicted by SAPS 3. The mean values for the PA (4.2 ± 1.0) and OPNI (38.7 ± 8.3) were lower than the referen...

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“…Com relação à ASG 25 , o método de avaliação nutricional utilizado nosso estudo, pode-se citar que este instrumento depende da memória do entrevistado, com relação a algumas perguntas. Outras desvantagens relacionam-se à precisão diagnóstica depender da experiência do entrevistador e também a ausência de critérios quantitativos que monitorem a evolução do paciente 26 . Segundo o Projeto Diretrizes, no que se refere à triagem e avaliação do estado nutricional, apesar da grande variedade de medidas nutricionais, não se dispõe, até o momento, de um método padrão-ouro 27 .…”

Section: Discussionunclassified