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Abstract(s)
Fundamentação / Objetivos: A cirrose hepática é caracterizada por um processo de catabolismo acelerado envolvendo a perda de proteínas musculares, forte preditor de morbilidade e mortalidade. A desnutrição associada é multifatorial, compreende redução da massa muscular, força e função (sarcopenia). Este estudo pretende avaliar o estado nutricional de doentes internados no serviço de Gastrenterologia, do Hospital Garcia de Orta, Almada. Métodos: Estudo observacional transversal. Foram aplicados questionários de identificação do risco (IRN) e avaliação do estado nutricional (AEN), no início e no final do internamento hospitalar: Nutritional Risk Screening-2002 (NRS-2002), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), Subjective Global Assessment (SGA) e Royal Free Hospital-Global Assessment (RFH-GA). Foram recolhidos parâmetros bioquímicos e efetuada avaliação antropométrica, avaliação da capacidade funcional e avaliação da ingestão alimentar. Resultados: Dos 63 doentes, 46 (73%) eram do sexo masculino e 17 (27%) do sexo feminino com idade média de 63,3 ± 10,7 anos; critério Child-Pugh A: B: C - 4:29:29, sendo a etiologia alcoólica a mais prevalente (n = 43). O período médio de internamento foi de 17,3 ± 13,5 dias [3,75]. Entre a primeira e a segunda avaliação verificou-se melhoria dos resultados dos questionários de IRN e AEN, pela aplicação do NRS-2002 (p = 0,043), do RFH-NPT (p = 0,000), do SGA (p = 0,000) e do RFH-GA (p = 0,008). Relativamente à força de preensão não existe diferença estatisticamente significativa entre os dois momentos de avaliação (p = 0,062). A intervenção nutricional foi aplicada a todos os doentes, comparando os dois momentos, verificaram-se diferenças estatisticamente significativas com um aumento significativo da ingestão de todos os macro (p = 0,000) e micronutrientes (p = 0,000-0,001) avaliados. Conclusão: A prevalência da desnutrição foi elevada. A intervenção nutricional personalizada teve impacto na melhoria dos questionários aplicados de IRN e AEN, da dinamometria e aumento da ingestão alimentar.
ABSTRACT - Background & Aims: Liver cirrhosis is characterized by an accelerated catabolic process involving loss of muscle proteins, a strong predictor of morbidity and mortality. Associated malnutrition is multifactorial, comprising reduced muscle mass, strength, and function (sarcopenia). Associated malnutrition is multifactorial, comprising reduced muscle mass, strength, and function (sarcopenia), as well as loss of subcutaneous and visceral fat mass. This study aims to evaluate the nutritional status of patients hospitalized in the Gastroenterology service of Hospital Garcia de Orta, Almada. Methods: Cross-sectional observational study. Nutritional risk screening and nutritional status assessment questionnaires were applied at the beginning and end of hospital stay: Nutritional Risk Screening-2002 (NRS-2002), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), Subjective Global Assessment (SGA) and Royal Free Hospital-Global Assessment (RFH-GA). The study included biochemical and anthropometric parameters, dynamometry, and nutritional intervention. Results: From the total of 63 patients, 46 (73%) were male and 17 (27%) were female (mean age, 63.3 ± 10.7 years); Child-Pugh criterion A: B: C - 4:29:29) with alcoholic etiology the most prevalent (n = 43). The mean hospital stay was 17.3 ± 13.5 days [3;75]. There was an improvement in the results of the nutritional risk screening and nutritional status assessment questionnaires, either by applying NRS-2002 (p = 0.043), RFH-NPT (p = 0.000), SGA (p = 0.000) and RFH-GA (p = 0.008). Regarding grip strength, there was no statistically significant difference observed between the two assessment moments (p = 0.062). The nutritional intervention was applied to all patients, comparing the two moments, there were statistically significant differences with a significant increase in the intake of all macronutrients (p = 0.000) and micronutrients evaluated (p = 0.000-0.001). Conclusions: There was a high prevalence of malnutrition. After nutritional intervention was an improvement in the applied questionnaires, grip strength and an increase in food intake.
ABSTRACT - Background & Aims: Liver cirrhosis is characterized by an accelerated catabolic process involving loss of muscle proteins, a strong predictor of morbidity and mortality. Associated malnutrition is multifactorial, comprising reduced muscle mass, strength, and function (sarcopenia). Associated malnutrition is multifactorial, comprising reduced muscle mass, strength, and function (sarcopenia), as well as loss of subcutaneous and visceral fat mass. This study aims to evaluate the nutritional status of patients hospitalized in the Gastroenterology service of Hospital Garcia de Orta, Almada. Methods: Cross-sectional observational study. Nutritional risk screening and nutritional status assessment questionnaires were applied at the beginning and end of hospital stay: Nutritional Risk Screening-2002 (NRS-2002), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), Subjective Global Assessment (SGA) and Royal Free Hospital-Global Assessment (RFH-GA). The study included biochemical and anthropometric parameters, dynamometry, and nutritional intervention. Results: From the total of 63 patients, 46 (73%) were male and 17 (27%) were female (mean age, 63.3 ± 10.7 years); Child-Pugh criterion A: B: C - 4:29:29) with alcoholic etiology the most prevalent (n = 43). The mean hospital stay was 17.3 ± 13.5 days [3;75]. There was an improvement in the results of the nutritional risk screening and nutritional status assessment questionnaires, either by applying NRS-2002 (p = 0.043), RFH-NPT (p = 0.000), SGA (p = 0.000) and RFH-GA (p = 0.008). Regarding grip strength, there was no statistically significant difference observed between the two assessment moments (p = 0.062). The nutritional intervention was applied to all patients, comparing the two moments, there were statistically significant differences with a significant increase in the intake of all macronutrients (p = 0.000) and micronutrients evaluated (p = 0.000-0.001). Conclusions: There was a high prevalence of malnutrition. After nutritional intervention was an improvement in the applied questionnaires, grip strength and an increase in food intake.
Description
Mestrado em Nutrição Clínica
Keywords
Nutrição Cirrose hepática Avaliação do estado nutricional Intervenção nutricional Nutrition Liver cirrhosis Nutritional assesment Nutritional intervention
Citation
Heitor PC. Impacto da intervenção nutricional no estado nutricional e no tempo de internamento em doentes com cirrose hepática [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa - Faculdade de Medicina da Universidade de Lisboa; 2022.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa