ABSTRACT
Background: Hematological cancer patients are prone to the development of sarcopenia and impaired nutritional and functional status. SARC-CalF is a screening tool for the risk of sarcopenia that has shown good results in this population. This study aimed to identify the risk of sarcopenia by SARC-CalF and to verify its association with nutritional status and Hand Grip Strength (HGS) in patients with hematological cancer. Materials and Methods: Adult patients, of both sexes, with hematological cancer, and in outpatient care participated in the study. We measured the Hand Grip Strength of the Dominant Hand (HGSD) and the Adductor Pollicis Muscle Thickness of the Dominant Hand (APMTD). Moreover, we applied the Patient-Generated Subjective Global Assessment (PG-SGA) and SARC-CalF. Data were analyzed with SPSS® software, 22.0, with a significance level of 5.0%. Results: Fifty-one patients aged an average of 60.4 ± 15.1 years were evaluated. Of those, 58.8% were elderly, 51% female, and 80.4% declared themselves non-white. The predominant diagnosis was Mature B Lymphoid Cell Neoplasia (37.7%), and 60.8% of the patients had a diagnosis time of ≤ 3 years. PG-SGA revealed that 35.3% of the patients were malnourished; APMTD and HGSD revealed that 60.8% and 25.5% had reduced muscle strength, respectively. SARC-CalF exposed that 39.2% of the patients were at risk for sarcopenia. Significant associations were found between SARC-CalF and diagnosis time ≤ 3 years (p = 0.039), PG-SGA (p = 0.020), APMTD (p = 0.039) and HGSD (p = 0.002). After binary logistic regression adjusted for age and sex, the reduced HGSD remained associated with the risk of sarcopenia. Conclusion: SARC-CalF identified a risk of sarcopenia in 39.2% of patients. The reduced HGSD was associated with the risk of sarcopenia.
ABSTRACT
Introduction: hematological cancers account for 9% of all cancers and their progression and treatment directly affect quality of life (QoL).Objective: this study assessed QoL and associated factors in patients with hematological cancer according to the EORTC QLQ-C30.Methods: cross-sectional study carried out from August 2017 to June 2019. We included adults and the elderly of both sexes, with hematological cancer, undergoing oral or venous chemotherapy. Nutritional status was assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and QoL by EORTC QLQ-C30.Results: fifty-one patients aged in average 60.0 ± 15 years were evaluated. Of these, 51.0% were women, 80.4% were non-white, 37.3% had B lymphoid cell neoplasia, 60.8% had been diagnosed for ≤ 3 years, 77.1% were on chemotherapy, and 64.7% were well- nourished. The scores for global health status and functional scales were high and for symptoms and single items they were low, indicating good QoL and functionality and low symptomatology. After multivariate linear regression, the time of diagnosis ≤ 3 years was associated with functional performance (p <0.05) and malnutrition was associated with cognitive function (p <0.05) and with symptoms of fatigue, nausea and vomiting, and insomnia (p <0.05).Conclusions: quality of life and functionality considered adequate were observed. Time of diagnosis and malnutrition were the variables that were associated with physical and cognitive function and with the presence of fatigue, nausea and vomiting and insomnia, according to the EORTC QLQ-C30.
Introdução: os cânceres hematológicos são responsáveis por 9% de todos os cânceres e sua progressão e tratamento afetam diretamente a qualidade de vida (QV).Objetivo: avaliar a QV e fatores associados em pacientes com câncer hematológico de acordo com o EORTC QLQ-C30.Método: estudo transversal realizado de agosto de 2017 a junho de 2019. Foram incluídos adultos e idosos de ambos os sexos, com câncer hematológico, em quimioterapia oral ou venosa. O estado nutricional foi avaliado pela Avaliação Subjetiva Global Gerada pelo Paciente (PG-SGA) e a QV pelo EORTC QLQ-C30.Resultados: foram avaliados 51 pacientes com idade média de 60,0 ± 15 anos. Destes, 51,0% eram mulheres, 80,4% eram não brancos, 37,3% apresentavam neoplasia de células linfoides B, 60,8% tinham diagnóstico ≤ 3 anos, 77,1% estavam em quimioterapia e 64,7% estavam bem nutridos. As pontuações para o estado de saúde global e escalas funcionais foram altas e para sintomas e itens únicos foram baixas, indicando boa QV e funcionalidade e baixa sintomatologia. Após regressão linear multivariada, o tempo de diagnóstico ≤ 3 anos foi associado ao desempenho funcional (p <0,05) e a desnutrição foi associada à função cognitiva (p <0,05) e aos sintomas de fadiga, náuseas e vômitos e insônia (p <0,05).Conclusões: foi observada qualidade de vida e funcionalidade consideradas adequadas. O tempo de diagnóstico e a desnutrição foram as variáveis que se associaram com o comprometimento da função física e cognitiva e com a presença de fadiga, náuseas e vômitos e insônia, segundo o EORTC QLQ-C30.
ABSTRACT
BACKGROUND: Cardiovascular diseases represent the leading cause of death worldwide, in addition to having a direct negative impact on quality of life, functional capacity and nutritional status. Studies show high prevalence of malnutrition in patients undergoing cardiac surgery. It is known that cardiac surgery can also lead to changes in nutritional status, through surgical trauma, systemic inflammation and, often, delay in the initiation of nutritional support. On the other hand, the role of nutritional support as a driver of clinical outcomes in different surgical populations is well described in the literature. OBJECTIVE: To review the literature in order to assess the effect of perioperative oral or enteral nutritional support on clinical outcomes of cardiac patients undergoing cardiac surgery. METHODOLOGY: The search was conducted in February 2021 in the following databases: EMBASE, PubMed/MEDLINE, Scopus and Web of Science. Randomized clinical trials (RCT) and retrospective studies were selected, carried out with patients with heart disease, undergoing cardiac surgery and aged 18 years or over. The Outcomes of interest were: length of hospital stay, length of stay in the ICU, time on ventilatory support, mortality rate, clinical complications and use of vasoactive drugs in the postoperative period. RESULTS: Ten studies were included in this systematic review, of which 7 were RCTs and 3 were cohorts. The most prevalent surgery was myocardial revascularization. Six studies evaluated oral nutritional support, two enteral nutritional support and two analyzed both. Two studies found a significant reduction in the length of hospital and ICU staying associated with preoperative intake of carbohydrate-based beverages. Only one study observed a significant reduction in the requirement for ventilatory support after cardiac surgery, after preoperative carbohydrate-based drinks and early postoperative enteral nutrition. There was no influence of nutritional support on mechanical ventilation length and mortality. CONCLUSION: Most studies showed that nutritional support did not reduce hospital and ICU staying. Nutritional support benefits were demonstrated in studies that offered preoperative oral carbohydrate drinks. No association was observed between nutritional support and duration of mechanical ventilation or mortality rate. Most studies did not find any influence of nutritional support on the need and/or dosage of vasoactive drugs in the postoperative period of cardiac surgery.
