Thickness of the adductor pollicis muscle in nutritional assessment of surgical patients

Abstract

Objective To evaluate the correlation between thickness of the muscle adductor pollicis and anthropometric measurements, body mass index and Subjective Global Assessment in the nutritional assessment of surgical patients.Methods The study population comprised patients admitted to the general and reconstructive surgery unit of a university hospital in the city of Vitória (ES), Brazil. The inclusion criteria were patients evaluated in the first 48 hours of admission, aged ≥20 years, hemodynamically stable, with no edema or ascites. Data analysis was performed using the software Statistical Package for Social Science 21.0, significance level of 5%.Results The sample consisted of 150 patients that were candidates to surgery, mean age of 42.7±12.0 years. The most common reasons for hospitalization were surgical procedures, gastrintestinal diseases and neoplasm. Significant association was observed between thickness of adductor pollicis muscle and Subjective Global Assessment (p=0.021) and body mass index (p=0.008) for nutritional risk. Significant correlation was found between thickness of adductor pollicis muscle and arm muscle circumference, corrected arm muscle area, calf circumference and body mass index. There were no significant correlations between thickness of adductor pollicis muscle and triceps skinfold and age.Conclusion The use of thickness of adductor pollicis muscle proved to be an efficient method to detect malnutrition in surgical patients and it should be added to the screening process of hospitalized patients, since it is easy to perform, inexpensive and noninvasive.

Adductor Pollicis Muscle Thickness and Prediction of Postoperative Mortality in Patients With Stomach Cancer

“…APMT also had a good prediction of 30-day mortality considered as a good outcome in clinical investigations. The median of APMT found is similar to that presented by Valente et al 29 in patients submitted to surgical procedures, including those ones with cancer as well.…”

“…There are few published studies assessing APMT 12 , 19 , 25 , 29 and its relation with other nutritional parameters predicting both, mortality and length of stay. Distinct cutoffs have been suggested from different studies in specific clinical condition such as intensive care 7 , 10 , 14 , 17 , breast cancer 2 , kidney dysfunction 24 , hemorrhagic stroke 22 and general gastrointestinal surgical procedures 6 , 19 .…”

“…Among the conventional anthropometric measurements, evaluation of adductor pollicis muscle thickness (APMT) appears as an important variable of objective measure to assess muscle compartment, being considered a quick, inexpensive and noninvasive method 29 . Patient-Generated Subjective Global Assessment (PG-SGA) has been used as a gold standard in many studies.…”

Associação entre Estado Nutricional e Força de Preensão Manual em Pacientes Oncológicos em Cuidados Paliativos

“…Por haver poucos estudos realizados com a mesma população, não foi possível comparar a incidência de desnutrição com a EMAP em pacientes oncológicos paliativos. Mas, em contrapartida, a EMAP é bastante estudada como um parâmetro para diagnóstico do estado nutricional de pacientes cirúrgicos, conforme estudo realizado por Valente et al 26 , no qual, em uma amostra de 150 pacientes candidatos à cirurgia, 40% (n=60) foram diagnosticados pela EMAP como desnutridos.…”

“…Em contrapartida, em um estudo com 110 pacientes cirúrgicos, no qual a indicação de cirurgia em 33,6% (n=37) era em virtude das neoplasias, realizado por Valente et al 26 , foi concluído que a EMAP é um método eficiente na detecção de desnutrição. Portanto, o EMAP parece ser um bom preditor em alguns grupos de pacientes; mas, na área de cuidados paliativos oncológicos, seria necessária a realização de mais estudos e com uma amostragem maior.…”