RESUMO
ABSTRACT The assessment of the nutritional status of hospitalized patients is fundamental to the establishment of the diagnosis. For bedridden patients, however, it is not possible to determine simple measures, such as weight and height, which are the most widely used variables for nutritional assessments. Objective: Compare real and estimated anthropometric measures in hospitalized patients. Methods: A cross-sectional study was conducted with adult (>18 years of age) and senior patients (>60 years of age) admitted for clinical or surgical treatment in the general surgery infirmary of Governador Paulo Guerra Restauração Hospital. Data (sex, age, clinical diagnosis, real weight, real height, body mass index, knee height and arm circumference) were collected using nutritional follow-up charts and tabulated using Excel 2016. Statistical analyses were performed in SPSS® version 21.0. Results: One hundred and twenty patients participated in the study (median age: 55 years). Most were adults (73.3%) and women (53.3%). The mean differences in weight between the estimated and real measures were statistically significant (p=0.000), with an overestimation of this variable. Regarding height, the estimated values differed significantly from the real values in both men and women (p<0.000) and the difference was larger among the seniors (mean: -0.072). No significant difference was found between the real and estimated body mass index (p= 0.44). Conclusion: In the comparison of methods for estimating weight and height to real measures, a tendency was found to overestimate these body measures.
RESUMEN La evaluación del estado nutricional de los pacientes hospitalizados es esencial para establecer su diagnóstico. Sin embargo, para los pacientes postrados en cama, no se pueden realizar medidas sencillas como el peso y la altura, que son las más utilizadas para el diagnóstico nutricional. Objetivo: Comparar mediciones antropométricas reales y estimadas en pacientes hospitalizados. Metodología: Estudio transversal, que incluye pacientes adultos (>18 años) y personas mayores de 60 años, ingresados para tratamiento clínico o quirúrgico en la sala de cirugía general del Hospital da Restauração Governador Paulo Guerra. Los datos (sexo, edad, diagnóstico clínico, peso real, altura real, índice de masa corporal, altura de la rodilla y circunferencia del brazo) se recopilaron mediante los formularios de monitoreo nutricional y se tabularon en el software Excel 2016. Los análisis estadísticos se realizaron con SPSS®, versión 21.0. Resultados: 120 pacientes con mediana de 55 años, en su mayoría adultos (73,3%) y mujeres (53,3%). Las diferencias promedio entre las mediciones estimadas y reales fueron estadísticamente significativas, con sobreestimación del peso (p<0,0001). Con respecto a la altura, fue posible identificar que las medidas estimadas diferían significativamente (p<0,0001) de las reales para hombres y mujeres, y que esta variación era aún mayor entre los ancianos (media: -0,072). No hubo diferencias estadísticamente significativas entre el índice de masa corporal real y el estimado (p= 0,44). Conclusión: Al comparar las metodologías para estimar el peso y la altura con las mediciones reales, fue posible observar una tendencia de los métodos a sobreestimar estas mediciones corporales.
RESUMO
RESUMO Objetivo: avaliar o perfil clínico, cirúrgico e nutricional de pacientes cirúrgicos internados em um hospital de referência da cidade de Recife - PE. Métodos: estudo de caráter transversal, realizado nas enfermarias do Serviço de Cirurgia Geral do Hospital da Restauração Governador Paulo Guerra, no período de junho a setembro de 2018. Foram incluídos pacientes adultos e idosos de ambos os sexos, submetidos a procedimentos toracoabdominais e cirurgias abdominais, de caráter eletivo ou de emergência, em que a avaliação do estado nutricional pôde ser realizada em até 72 horas da admissão hospitalar. Foram coletados dados sobre o estado nutricional, sobre os procedimentos cirúrgicos, assim como, informações clínicas e bioquímicas. Resultados: foram estudados 140 pacientes, com mediana de idade de 45 anos, 59,3% do sexo feminino, sendo que 23% apresentavam-se desnutridos, através da Avaliação Subjetiva Global. A mediana do tempo de jejum pré-operatório para as cirurgias de porte I foi de 15 horas e para as de porte II, 13,5 horas. Maior tempo de permanência hospitalar no pós-operatório apresentou forte correlação com o tempo total de internamento em ambos os portes cirúrgicos. Pacientes desnutridos apresentaram maior tempo de jejum perioperatório e de permanência hospitalar quando comparados com os bem nutridos (p<0,001). Conclusão: o tempo de jejum perioperatório das cirurgias eletivas esteve acima do que é preconizado pela literatura. Pacientes com maior tempo de jejum permaneceram mais tempo internados.
ABSTRACT Objective: to evaluate the clinical, surgical, and nutritional profile of surgical patients admitted to a reference hospital in Recife city, Pernambuco state, Brazil. Methods: a cross-sectional study carried out in the wards of the General Surgery Service of Hospital da Restauração Governador Paulo Guerra, from June to September 2018. We included adult and elderly patients (both genders) who were submitted to thoracoabdominal procedures and elective or emergency abdominal surgeries, and in which the assessment of nutritional status could be performed within 72 hours of hospital admission. Data on nutritional status and surgical procedures, as well as clinical and biochemical information, were collected. Results: we studied 140 patients with median age of 45 years. Among all, 59.3% were female and 23% malnourished, according to Subjective Global Assessment. The median preoperative fasting time was 15 hours for size I surgeries and 13.5 hours for size II ones. Longer postoperative hospital stay showed a strong correlation with the total length of hospital stay in both surgical sizes. Malnourished patients had a longer period of perioperative fasting and hospital stay when compared to well-nourished patients (p<0.001). Conclusion: the perioperative fasting time for elective surgeries was longer than recommended by literature. Patients with longer fasting spent more time in hospital.