Risco nutricional em pacientes adultos e idosos de um hospital do sul do Brasil

Abstract

RESUMOObjetivos: Verificar a prevalência do risco nutricional na admissão hospitalar, utilizando o protocolo Nutrition Risk Screening (NRS 2002) e identificar quais foram os aspectos desse protocolo que mais contribuiram para o escore final. Métodos: Foi realizado um estudo transversal com pacientes adultos e idosos de ambos os sexos, admitidos nos departamentos de internação clínica (exceto maternidade, emergência e unidade de saúde mental) de um hospital da cidade de Farroupilha, Rio Grande do Sul. Os indivíduos foram avaliados através do protocolo NRS 2002, nos primeiros três dias após admissão hospitalar. Resultados: Foram avaliados 386 pacientes, com idade média de 56,7±20,7 anos, sendo 198 (51,3%) do sexo feminino. O risco nutricional esteve presente em 57 (14,8%) dos pacientes. Na primeira parte da triagem nutricional, 315 (81,6%) pacientes tiveram pelo menos uma resposta positiva indicando risco nutricional, sendo a redução de ingestão alimentar na última semana a mais prevalente. Na segunda parte observou-se que em relação ao estado nutricional, a proporção do estado grave esteve presente em 21 pacientes (36,8% da amostra em risco). Quanto à gravidade da doença, prevaleceu o fator de risco leve em 29 (50,9%) pacientes. A pontuação adicional, através da pontuação da variável idade acima de 70 anos, contribuiu para caracterizar o risco nutricional em 35 pacientes (61,4%). Conclusões: Observou-se elevada proporção de pacientes em risco nutricional, sendo a redução na ingestão alimentar na última semana a variável que mais contribuiu para dar sequência à segunda etapa do processo de triagem nutricional. DESCRITORES: AVALIAÇÃO NUTRICIONAL; INGESTÃO DE ALIMENTOS; ASSISTÊNCIA AO PACIENTE. ABSTRACT Aims:To determine the prevalence of nutritional risk at admission using the Nutrition Risk Screening (NRS 2002) protocol, and to identify which aspects of this protocol contributed most to the final score. Methods: A cross-sectional study included adult and elderly patients of both sexes, admitted to clinical departments (except maternity, emergency and mental health unit) of a hospital in the city of Farroupilha, Rio Grande do Sul state, Brazil. Individuals were assessed through NRS 2002 in the first three days after admission. Results: A total of 386 patients were evaluated. They had a mean age of 56.7±20.7 years, and 198 (51.3%) were female. Nutritional risk was present in 57 (14.8%) patients. In the first part of the nutritional screening, 315 (81.6%) patients had at least one positive response indicating nutritional risk, being the reduction of food intake in the last week the most prevalent. In the second part it was noted that, in relation to nutritional status, the proportion of the severe condition was present in 21 patients (36.8% of the sample at risk). In relation to severity of disease, the prevailing condition was mild disease, in 29 (50.9%) patients. Additional score given by age over 70 years helped to characterize nutritional risk in 35 patients (61.4%). Conclusions: There was a high proportion of p...

Comparação dos critérios da nrs-2002 com o risco nutricional em pacientes hospitalizados

“…Regarding the answers of the initial part of the screening tool, results were similar to those found by Aquino and Philippi 40 , Leonhardt and Paluto 42 and Alvarez-Altamirano et al 28 . Gabbardo and Boscaini 38 found the opposite, and the most prevalent answer was the reduction of food intake in the last week followed by weight loss in the last three months. For Giryes et al 41 the most prevalent answers, in descending order, were critically ill patients, weight loss in the last three months, reduction in food intake in the last week and BMI < 20.5kg/m 2 .…”

“…Similar results were found by Giryes et al 41 and Alvarez-Altamirano et al 28 . On the other hand, Gabbardo and Boscaini 38 found that 81.6% of patients had provided at least one affirmative answer. Regarding the answers of the initial part of the screening tool, results were similar to those found by Aquino and Philippi 40 , Leonhardt and Paluto 42 and Alvarez-Altamirano et al 28 .…”

“…Significant weight loss is directly associated with reduced food intake that is influenced by psychological, cultural, and social factors. In addition, difficulties in chewing and swallowing and chronic problems, such as pain or difficulties in preparing meals, are possible reasons for the decrease in oral food intake, mainly in the elderly 6,38 . However, it is worth noting that both weight loss and reduced food intake are not simple variables to obtain, since both suffer interference from personal perceptions, memory and even the patient's unwillingness to dialogue with the professional and may not represent reality.…”

“…However, it is worth noting that both weight loss and reduced food intake are not simple variables to obtain, since both suffer interference from personal perceptions, memory and even the patient's unwillingness to dialogue with the professional and may not represent reality. Nevertheless, this situation is presented by all existing nutritional screening methods 38,40 .…”