A rational approach to nutritional assessment

Soeters, Peter B.; Reijven, P.L.M.; Schueren, Marian A.E. de van der; Schols, Jos M. G. A.; Halfens, Ruud J.G.; Meijers, J.M.M.; Gemert, Wim G. van

doi:10.1016/j.clnu.2008.07.009

Cited by 238 publications

(182 citation statements)

References 92 publications

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“…Therefore, we could only compare two assessment scores, with anthropometric and biochemical parameters reflecting different aspects of malnutrition (Covinsky et al, 2002;Soeters et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients

et al. 2010

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Background: Malnutrition occurs frequently in the elderly and is associated with increased morbidity and mortality. The mininutritional assessment (MNA) has been used most frequently in the geriatric literature. The nutritional risk screening 2002 (NRS) has been proposed as universal screening method for hospitalized patients. The aim of our study was to compare both tools as they are correlated with protein malnutrition. Methods: MNA, NRS, and markers of protein malnutrition were measured in 104 consecutive inpatients admitted to an acute geriatric ward. Results: The median age was 84 years (IQR: 78-89), 81 were females. The median body mass index was 23.1 kg/m 2 (IQR: 20-27.3), the median upper-arm and calf circumferences were 25 cm (IQR: 23-29) and 33 cm (IQR: 29-36). According to MNA, 23 patients were malnourished, 50 at risk of malnutrition, and 31 had a normal nutritional status. The NRS indicated that 35 were at moderate to severe risk of malnutrition and 69 at low risk. Serum prealbumin and retinol-binding protein concentrations were inversely associated with the severity of malnutrition as indicated by the NRS (P ¼ 0.06 and o0.01, respectively), whereas the MNA was not associated with these serum proteins. After adjustment for C-reactive protein and creatinine clearance, only retinol-binding protein concentrations were consistently associated with both malnutrition scores. Conclusions: The NRS seems to be superior compared with the MNA and serum proteins in identifying elderly patients at risk of malnutrition during acute intercurrent illness.

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Section: Discussionmentioning

confidence: 99%

Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients

et al. 2010

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“…A hipoalbuminemia pode apontar para um perfil de desnutrição nosocomial, e/ou ser um indicador de atividade inflamatória, 5,6,7 e/ou ainda um importante fator de risco para o desenvolvimento de complicações infecciosas pós-trauma 5 . Cooper et al também associaram os baixos níveis de albumina plasmática a doenças vasculares 24 .…”

Section: Doenças Motivadoras Da Internaçãounclassified

“…Idosos internados com diagnóstico de desnutrição, processo inflamatório grave, insuficiência renal e hepática apresentam estreita relação com hipoalbuminemia 5,6,7 . Esta condição concorre para um prognóstico desfavorável com período de internação hospitalar prolongada e maior risco de complicações clínicas 8,9 .…”

Section: Introductionunclassified

Albuminemia e terapia medicamentosa no prognóstico de idosos hospitalizados

Salgado

Vianna

Giavoni

et al. 2010

Rev. Assoc. Med. Bras.

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ResumoObjetivOs. O presente estudo teve por objetivo investigar a relação entre os níveis de albumina sérica, medicamentos utilizados, tempo de internação e número de doenças com o prognóstico de indivíduos idosos hospitalizados. MétOdOs. Estudo descritivo transversal e retrospectivo por meio de revisão de prontuários. Foram coletadas variáveis tais como: doença motivadora da internação, albuminemia, medicamentos utilizados e sua afinidade com a albumina e tempo de internação em uma população de idosos de um hospital público brasileiro. Foi utilizada a regressão múltipla para avaliar se a idade, dias de internação, medicamento com e sem afinidade a albumina, número de doenças motivadoras da internação foram preditores do óbito. A relação entre a variável dependente e as independentes foi analisada por Two-way ANOVA. ResultadOs. A amostra constituiu-se de 277 idosos, sendo 151 com hipoalbuminemia e sob uso de em média 6,6±3,80 medicamentos diferentes cuja maioria apresentava afinidade pela albumina (4,96 ± 2,64). Os resultados demonstraram que o número de medicamentos com afinidade a albumina, a albuminemia e o período de internação foram preditores do óbito (r=0.47; R2= 0.224), (F(8.170) = 6.13; p=0.001). A relação entre a variável dependente e as independentes resultou na equação matemática: (óbito= 0,545 -0,374 (albuminemia) -0,195 (dias de internação) + 0,175 (número de medicamentos com afinidade à albumina)). COnClusãO. A equação obtida para este estudo demonstrou que a albuminemia e os dias de internação foram inversamente correlacionados ao óbito e diretamente correlacionados com o elevado número de medicamentos ligados à albumina. 1,2 . No âmbito da saúde pública, o aumento da população idosa determina a modificação das necessidades por recursos capazes de proporcionar saúde, envolvendo medidas de prevenção ou intervenção com aporte a serviços médico-hospitalares e ao uso de medicamentos 3,4 .O processo de envelhecimento tem sido relatado na literatura como um fator contribuinte no aumento da demanda por serviços de saúde, havendo uma correlação com internações hospitalares mais frequentes e com tempo prolongado de ocupação do leito por idosos 2 . A maior prevalência de hospitalizações deste segmento etário está relacionada à presença de doenças crônicas não transmissíveis (DCNT) e a evolução da gravidade das doenças infecciosas.Idosos internados com diagnóstico de desnutrição, processo inflamatório grave, insuficiência renal e hepática apresentam estreita relação com hipoalbuminemia 5,6,7 . Esta condição concorre para um prognóstico desfavorável com período de internação hospitalar prolongada e maior risco de complicações clínicas 8,9 . Em adição, idosos com hipoproteinemia podem não ser responsivos a medicação e podem apresentar alterações no efeito farmacológico quando se administra medicamentos com afinidade a proteínas plasmáticas 8 . A relevância da afirmação recai sobre o uso de medicamentos como a principal ferramenta terapêutica em ambiente nosocomial, sobretudo na população idosa, que utiliza d...

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“…(7) Hypothyroidism, or underactive thyroid, develops when the thyroid gland fails to produce or secrete as much thyroxine (T 4 ) as the body needs. Because T 4 regulates such essential functions as heart rate, digestion, physical growth, and mental development, an insufficient supply of this hormone can slow life-sustaining processes, damage organs and tissues in every part of the body, and lead to life-threatening complications (8) Thyroid-stimulating hormone (also known as thyrotropin, thyrotropic hormone, TSH, or hTSH for human TSH) is a pituitary hormone that stimulates the thyroid gland to produce thyroxin (T 4 ), and then triiodothyronine (T 3 ) which stimulates the metabolism of almost every tissue in the body (9) In PEM, there are marked changes in secretion and metabolism of thyroid hormones and in the structure of thyroid gland. This results in reduction of the activity of the gland (3), as the body tries to adapt to low calorie intake.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Thyroid-stimulating hormone in Sudanese children patients with malnutrition

Abubaker¹,

Mohammed²,

Salih³

2018

IJASTR

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BackgroundMalnutrition is defined as a state of nutrition in which a deficiency or imbalance of energy, protein and other nutrients causes measurable adverse effects on tissue, body form (body shape, size and composition) and function. Objective This study was carried out to measure serum levels of Thyroid stimulating hormone in malnutrition children. Materials and Methods:A total of one hundred and twenty subjects were enrolled in this study, divided into three group (thirty of them, moderately malnourished (BMI < 15) , and thirty well nourished (BMI > 18) ) and thirty normal children as control , were collected from period between May to June 2017, chosen randomly from Mohammed AL Amin Hamid Hospital for Pediatric in Khartoum State (Sudan) , to assess Serum thyroid stimulating hormone in Sudanese children patients with malnutrition. Serum thyroid stimulating hormone was measured by using Enzyme Immune Sorbent Assay (ELISA) and results were analyzed using statistical of package social science (SPSS), computer program. ResultsThe study showed that, Children with malnutrition had significantly high level in mean serum thyroid stimulating hormone in moderately malnourished compared to control group(6.91±.97 versus 1.90±1.01 , P value =0.000) and there was significant increase in mean level of TSH hormone in well nourished compared to control group. (2.95 ± 1.38 versus1.90± 1.01, P value =0.001). Also the result showed, there was insignificant different in the mean of serum TSH in males compared to females children patients. Moderately malnourished (6.72 ±0.94) (7.09±0.99) , well nourished (2.95 ±1.46) (2.95±1.34) , with P value (0.990) (0.298) respectively. There was significantly decrease in BMI in patients compared to control group. (Mean ± SD: 15.28 ± 2.28 kg/m2 versus 19.25 ± 2.48 kg/m2). In this study 50% of patient were males and 50% of patients were females. The result showed 28% of patients at age 7 years, 23% of patients at age 6 years, 19% of patients at 5years, 11% of patients at 3 years and 3% of patients at 2 years. Conclusion In conclusion: Children with malnutrition had significantly high levels in means serum thyroid stimulating hormone (TSH) compared to control group.

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A rational approach to nutritional assessment

Cited by 238 publications

References 92 publications

Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients

Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients

Albuminemia e terapia medicamentosa no prognóstico de idosos hospitalizados

Evaluation of Thyroid-stimulating hormone in Sudanese children patients with malnutrition

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