RESUMO
Introduction: Nutrition assessment of critically ill patients is challenging but it should be part of the clinical nutrition routine in the hospital setting. Objective: To assess the nutritional risk and prognosis of patients admitted to the intensive care unit (ICU) of a University Hospital in Natal, Brazil. Methods: Cross-sectional study developed with adult and elderly patients between February 2017 and February 2020. The nutritional risk was detected by the modified Nutrition Risk in Critically Ill score (mNUTRIC score). The nutritional prognosis was assessed using the phase angle (PA), calculated from the resistance and reactance values provided by bioimpedance. Mann-Whitney test was used to verify the association of mNUTRIC-score and PA with the outcome (hospital discharge or death). Spearman's correlation coefficient was used to verify the correlation between mNUTRIC-score and PA. Results: A total of 55 patients were included in this study. The average value of the NUTRIC score and PA was 3.13 ± 2.35 and 4.19 ± 1.21, respectively. Most patients had low nutritional risk. Among them, 81.8% were discharged and 18.2% died. Both mNUTRIC-score (p≤0.0001) and PA (p=0.04) were associated with the clinical outcome. These two parameters were negatively correlated (r=-0.3804; p=0.0059). Conclusion: Most of the patients had a low nutritional risk determined by the mNUTRIC-score. Those with high nutritional risk had a worse outcome (death). A negative correlation was observed between the mNUTRIC score and the PA, showing that the higher the nutritional risk, the worse prognosis was found in critically ill patients.
RESUMO
Introdução: O câncer é caracterizado pela multiplicação desordenada de células de um dado tecido, com potencial para invadir outros órgãos e tecidos. O conhecimento da extensão anatômica do câncer e sua capacidade de infiltração são importantes para nortear terapias e prognóstico, e a evolução dessa doença tem forte impacto negativo no estado nutricional do paciente. O ângulo de fase (AF) se apresenta como ótima ferramenta prognóstica para esse grupo. Objetivo: Associar o ângulo de fase padronizado (AFP) com o estadiamento clínico em indivíduos com câncer. Método: Estudo observacional e transversal, realizado com adultos e idosos com câncer não hospitalizados. As informações clínicas e o estadiamento clínico (TNM) do câncer foram obtidos por meio de prontuário eletrônico. Foi realizada a Avaliação Subjetiva Global Produzia pelo Próprio Paciente (ASG-PPP), e calculados o AF, mediante os valores obtidos pela bioimpedância e, em seguida, o AFP. Resultados: Participaram da pesquisa 25 voluntários com média de idade de 58,3 anos (±13,7), sendo 54,8% do sexo feminino e 54,8% idosos. O tipo de câncer mais frequente foi o de estômago (36%); 44% dos participantes tinham estádios clínicos II e 56%, III ou IV. Segundo a ASG-PPP, 74% dos voluntários apresentavam algum grau de comprometimento nutricional (escores B ou C), e foi detectada associação positiva entre o AFP e o estadiamento tumoral (p>0,0414). Conclusão: O AFP se relacionou positivamente com o estadiamento clínico em indivíduos com câncer
Introduction: Cancer is characterized by the abnormal growth of cells in a tissue, with the potential to invade another organs and tissues. The knowledge of the anatomical extent of cancer and its infiltration capacity are important to guide therapies and prognosis, and the evolution of this disease has severe negative impact on the patient's nutritional status. Phase angle (PA) is an excellent prognostic tool for this group. Objective: To associate the standardized phase angle (SPA) with clinical staging in cancer patients. Method: Observational and cross-sectional study with adults and older adults with cancer non-hospitalized. Clinical information and clinical staging (TNM) of cancer were obtained from electronic charts. PatientGenerated Subjective Global Assessment (PG-SGA) was performed, and the PA was calculated using values collected by bioimpedance and then the standardized PA (SPA). Results: 25 volunteers participated, with mean age of 58.3 years (±13.7), 54.8% females and 54.8% older adults. The most frequent tumor site was in the stomach (36%), 44% of the participants were in clinical stages II and 56%, III or IV. According to the PG-SGA, 74% of the volunteers had some degree of nutritional impairment (score B or C), and a positive association was detected between SPA and tumor staging (p>0.0414). Conclusion: SPA was positively related to clinical staging in individuals with cancer
Introducción: El cáncer se caracteriza por la multiplicación desordenada de células en un tejido, con potencial para invadir otros órganos y tejidos. El conocimiento de la extensión anatómica del cáncer y su capacidad de infiltración son importantes para orientar las terapias y el pronóstico, y la evolución de esta enfermedad tiene un fuerte impacto negativo en el estado nutricional del paciente. Y el ángulo de fase (AF) es una excelente herramienta de pronóstico para este grupo. Objetivo: Asociar el ángulo de fase estandarizado con la estadificación en individuos con cáncer. Método: Estudio observacional y transversal, realizado con adultos y ancianos con cáncer no hospitalizados. La información clínica y la estadificación clínica (TNM) del cáncer se obtuvieron a través de registros médicos electrónicos, y se realizó la Valoración Global Subjetiva Generada por el Paciente (VGSGP) y se calculó el AF y AF estandarizado utilizando los valores obtenidos por bioimpedancia y luego el AF estandarizada. Resultados: Participaron 25 voluntarios, con una edad promedio de 58,3 años (±13,7), 54,8% mujeres y 54,8% eran ancianos. El tipo de cáncer más frecuente fue el de estómago (36%), y el 44% de los participantes tenía estadios clínicos II y 56% III o IV. Según la VG-SGP 74% de los voluntarios presentaban algún grado de deterioro nutricional (puntuaciones B o C) y se detectó una asociación positiva entre el AF estandarizado y estadificación tumoral (p>0,0414). Conclusión: El AF estandarizada se relacionó positivamente con la estadificación en personas con cáncer