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Triagem nutricional em pacientes idosos oncológicos : um estudo multicêntrico luso-brasileiro
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Resumo(s)
O presente estudo pretendeu descrever o perfil nutricional de indivíduos idosos com cancro, obtido pela MNA-SF (Mini-avaliação Nutricional Versão Reduzida), e compará-lo com parâmetros antropométricos, localização do tumor e tempo de internamento. Comparou-se ainda a associação entre a sua classificação com a PG-SGA
(Avaliação Geral Subjetiva Gerada pelo Paciente).
Foram avaliados 146 doentes (idade≥65anos), internados no INCA (Instituto Nacional de Câncer), no Brasil, submetidos aos dois inquéritos referidos nas primeiras 24 horas de internamento. A amostra portuguesa (n=15), não serviu para motivos de comparação e discussão por ser pequena.
A caracterização da MNA-SF mostrou uma prevalência de doentes com redução da função motora, redução da ingestão alimentar e perda de peso nos últimos três meses. Avaliou-se ainda o grau de demência, o IMC e a CP (circunferência da perna) destes doentes. A média do score foi 7,73±3,24, com 49,3% de desnutridos. Verificaram-se associações (p<0,05) nos pacientes internados há mais de 30 dias, apresentando estes
maior prevalência de desnutrição, maior prevalência de perda de peso>3kg, de redução grave da ingestão alimentar, de CP<31cm e de mobilidade reduzida. A taxa de mortalidade foi de 13,7%, a maioria desnutridos. Dos internados, 55,5% foram por motivo clínico, maioritariamente desnutridos, e 44,5% por motivo cirúrgico, maioritariamente bem nutridos. Assim, verificou-se que os desnutridos apresentaram menor peso, IMC, CP, score e maior idade. Quanto a correlações, a CP apresentou forte com o peso (r=0,75), IMC (r=0,68) e score (r=0,61), enquanto que o score mostrou moderada com o peso (r=0,48) e IMC (r=0,49). A classificação da MNA-SF mostrou refletir melhor a desnutrição nesta população do que a PG-SGA (p=0,000).
Os resultados mostram que é benéfico recorrer à MNA-SF para identificar precocemente o estado nutricional em indivíduos idosos com cancro. A MNA-SF e a PG-SGA mostraram diferenças significativas nas suas classificações, podendo a MNASF ser uma boa ferramenta na descrição do perfil nutricional desta população.
The present study intends to describe the nutritional profile of elderly individuals with cancer, which was obtained from MNA-SF e compare it with anthropometrical parameters, tumor location and hospitalization period. Its relation with PG-SGA was also compared. 146 patients (age≥65 years) hospitalized at INCA, Brazil, were evaluated and submitted to both inquiries in the first 24 hours of hospitalization. The Portuguese sample (n=15) was shown to be too small to compare and discuss. Characterization of MNA-SF showed prevalence of patients with decreased motor function and food intake, and weight loss in the last three months. Degree of dementia, BMI and leg circumference (LC) of these patients was also evaluated. Average score was 7.73±3.24 with 49.3% of malnourished patients. Statistical significant data (p<0.05) showed that patients hospitalized for more than 30 days presented high values of malnourishment, weight loss (>3kg), severe reduction in food intake, LC<31 cm and reduced mobility. Mortality rate was 13.7%, mostly in malnourished patients. From the total number of hospitalizations, 55.5% were for clinical reasons, mostly malnourished, and 45.5% for surgical reasons, mostly well nourished. Accordingly, malnourished patients presented lower weight, BMI, LC, scored and majority. LC presents strong correlation with weight (r=0.75), BMI (r=0.68) and score (r=0.61), whereas score showed moderate correlation with weight (r=0.48) and BMI (r=0.49). MNA-SF classification was proven efficiently reflect malnourishment within this population than PG-SGA (p=0.000). Concluding, MNA-SF is a suitable method to early identify the nutritional state in elderly individuals with cancer. Both MNA-SF and PG-SGA presented significant differences in their classifications, and MNA-SF can be applied as an efficient tool to describe the nutritional profile in this population.
The present study intends to describe the nutritional profile of elderly individuals with cancer, which was obtained from MNA-SF e compare it with anthropometrical parameters, tumor location and hospitalization period. Its relation with PG-SGA was also compared. 146 patients (age≥65 years) hospitalized at INCA, Brazil, were evaluated and submitted to both inquiries in the first 24 hours of hospitalization. The Portuguese sample (n=15) was shown to be too small to compare and discuss. Characterization of MNA-SF showed prevalence of patients with decreased motor function and food intake, and weight loss in the last three months. Degree of dementia, BMI and leg circumference (LC) of these patients was also evaluated. Average score was 7.73±3.24 with 49.3% of malnourished patients. Statistical significant data (p<0.05) showed that patients hospitalized for more than 30 days presented high values of malnourishment, weight loss (>3kg), severe reduction in food intake, LC<31 cm and reduced mobility. Mortality rate was 13.7%, mostly in malnourished patients. From the total number of hospitalizations, 55.5% were for clinical reasons, mostly malnourished, and 45.5% for surgical reasons, mostly well nourished. Accordingly, malnourished patients presented lower weight, BMI, LC, scored and majority. LC presents strong correlation with weight (r=0.75), BMI (r=0.68) and score (r=0.61), whereas score showed moderate correlation with weight (r=0.48) and BMI (r=0.49). MNA-SF classification was proven efficiently reflect malnourishment within this population than PG-SGA (p=0.000). Concluding, MNA-SF is a suitable method to early identify the nutritional state in elderly individuals with cancer. Both MNA-SF and PG-SGA presented significant differences in their classifications, and MNA-SF can be applied as an efficient tool to describe the nutritional profile in this population.
Descrição
Tese de mestrado, Nutrição Clínica, Universidade de Lisboa, Faculdade de Medicina, 2016
Palavras-chave
Idoso MNA-SF Antropometria Desnutrição Cancro Teses de mestrado - 2016