Análise clínica e do estado nutricional de pacientes submetidos à ressecção de segmentos de intestino delgado

Abstract

Background: Segments of the digestive tract have specificities of nutrient absorption. The aim of this study was to identify factors related to outcome among patients submitted to intestinal resections in a university hospital. Material and methods: Retrospective, cross sectional study using a semi-structured specific form. A total of 169 medical records of patients submitted to intestinal resection from august 2007 to july 2013 were analyzed. Patients were grouped according to clinical evolution (hospital discharge / death) for analysis of the data. Results: Longer hospitalizations and age over 60 years were associated with a higher mortality rate. Among patients submitted to single (n=148) or multiple (n=21) enterectomy, the mortality rate was 33.8% (n=50 deaths) and 52.4% (n=11 deaths), respectively. Hospital discharge was more common among patients undergoing a single enterectomy. Among patients submitted to single resection, non-description of resected bowel segments increased the mortality rate (p=0.002). Remaining small intestine description was performed for 14 patients, and 11 of these patients met criteria for diagnosis of short bowel syndrome (SBS) (78.6%). SBS patients had a 90.9% mortality rate. For most enterectomized patients, no nutritional status assessment was performed (n=103, 60.9%). Patients classified as malnourished (n=19; 52.8%) had a higher mortality rate (p=0.032). Conclusion: The lack of description of the resected and / or remaining intestinal segments, as well as the non-evaluation of the nutritional status, contributed to the higher mortality rate of patients submitted to resection of bowel segments.