Association of Adductor Pollicis Muscle Thickness and Handgrip Strength with nutritional status in cancer patients.

BACKGROUND AND AIM: Malnutrition is common in patients with cancer, and its early diagnosis can reduce or prevent further complications and improve the clinical and nutritional prognosis. Adductor Pollicis Muscle Thickness (APMT) and Handgrip Strength have been explored in this population to identify a reduction in strength and muscle mass prior to the use of conventional methods. We aimed to correlate APMT and Handgrip Strength with conventional anthropometric variables in cancer patients and verify their association with nutritional status as determined by the Patient-Generated Subjective Global Assessment (PG-SGA). METHODS: A cross-sectional study was conducted with 80 patients diagnosed with cancer who were candidates for surgery. Nutritional status was obtained from the PG-SGA. Conventional anthropometric measurements were taken, as well as APMT and Handgrip Strength. Pearson's correlation analysis and multivariate linear regression were applied to detect the influence of variables on APMT and HGS. A significance level of 5.0% was considered. RESULTS: A high prevalence of malnutrition and the need for dietotherapic intervention was found, identified by the PG-SGA. Correlations between APMT and Handgrip Strength with anthropometric variables and with the PG-SGA score were observed. After regression adjustments, the variables that interacted with APMT were TSF and AC, and the PG-SGA score, corrected Muscle Arm Area (CAMA), and age interacted with Handgrip Strength. CONCLUSION: Correlations between anthropometric measurements and the PG-SGA score with APMT and Handgrip Strength were observed, even after adjusting for age and sex. These associations demonstrate that APMT and Handgrip Strength can be used with criterion in patients with cancer as complementary methods to evaluate nutritional risk and the need for nutritional intervention.

Scored Patient-Generated Subjective Global Assessment: risk identification and need for nutritional intervention in cancer patients at hospital admission / Escore da avaliação subjetiva global produzida pelo próprio paciente: Identificação do risco e necessidade de intervenção nutricional em pacientes com câncer na admissão hospitalar

Background: Malnutrition is one of the most common nutritional disorders in cancer patients, making early diagnosis and nutritional intervention necessary to minimize or prevent undesirable outcomes. Objective: To identify nutritional status and the need for nutritional intervention in cancer patients according to Patient-Generated Subjective Global Assessment (PG-SGA) and the scored PG-SGA at hospital admission, and to verify the association of the scored PG-SGA with objective methods of nutritional assessment Methods: A cross-sectional study was carried out in a university hospital with adult and elderly cancer patients of both sexes. Conventional anthropometric variables, body mass index, and PG-SGA within 48 hours of hospital admission were evaluated. The data were evaluated by Fisher's Exact test, ANOVA, Pearson's correlation, and multiple linear regression. Results: Of the 70 patients evaluated, 64 (95.7%) presented some degree of malnutrition according to PG-SGA. The total scored PG-SGA showed that 60 (91.4%) of patients had nutritional intervention (≥ 4 points) and 43 (61.4%) had nutritional risk (≥ 9 points). The scored PG-SGA was associated with objective variables of nutritional status. Conclusion: PG-SGA was able to efficiently identify malnutrition in its different stages, as well as the need for nutritional intervention at hospital admission. The PG-SGA score was associated with objective methods of nutritional assessment. PG-SGA and its score should be included in the initial evaluation of cancer patients, because they allow different evaluations in a single instrument

Introducción:La desnutrición es uno de los trastornos nutricionales más comunes en pacientes con cáncer, lo que hace que el diagnóstico precoz y la intervención nutricional adecuada sean fundamentales para minimizar o prevenir resultados indeseables. Objetivo: Identificar la presencia de desnutrición y la necesidad de intervención nutricional en pacientes con cáncer según Valoración Global Subjetiva Generada por el Paciente (VGS-GP) y su puntuación en la admisión hospitalaria, y verificar la asociación del score de la VGS-GP con métodos objetivos de la evaluación nutricional. Métodos: Estudio transversal, realizado en un hospital universitario, con pacientes oncológicos, adultos y ancianos, de ambos sexos. Se evaluaron las variables antropométricas convencionales y el índice de masa corporal aplicados a VGS-GP en hasta 48 horas de la admisión hospitalaria. Los datos se evaluaron por la prueba Exacta de Fisher, ANOVA, Correlación de Pearson y regresión lineal múltiple. Resultados: De los 70 pacientes evaluados, 67 (el 95.7%), presentaron algún grado de desnutrición según la VGS-GP. La puntuación total de la VGS-GP mostró que el 91.4% (60 pacientes) presentó la necesidad de intervención nutricional (≥ 4 puntos) y que el 61.4% (43 pacientes) presentó el riesgo nutricional (≥ 9 puntos). La puntuación de la VGS-GP se asoció con variables objetivas del estado nutricional. Conclusión: La VGS-GP y su puntuación fueron capaces de identificar de manera eficiente la desnutrición en sus diferentes etapas y la necesidad de intervención nutricional en la admisión hospitalaria. La puntuación de la VGS-GP se asoció a métodos objetivos de la evaluación nutricional. La VGS-GP y su puntuación deben ser incluidos en la evaluación inicial de los pacientes con cáncer al permitir diferentes evaluaciones en un único instrumento

No disponible

Associação entre desnutrição, escore prognóstico de Glasgow modificado e índice inflamatório nutricional em pacientes com câncer / Association between malnutrition, modified Glasgow prognostic score and nutritional inflammatory index in cancer patients

Introdução: A desnutrição é um achado comum em pacientes oncológicos e sua etiologia é multicausal, sendo influenciada significativamente pela resposta inflamatória sistêmica. Os indicadores de inflamação podem ser ferramentas úteis na avaliação nutricional dos pacientes com câncer. Objetivo: Avaliar a associação entre o Escore Prognóstico de Glasgow modificado e o Índice Inflamatório Nutricional (IIN) com a presença e o grau de desnutrição em pacientes com câncer. Método: Pacientes admitidos em um hospital universitário, com diagnóstico confirmado de câncer, participaram deste estudo. Exames laboratoriais de albumina e proteína C-reativa foram realizados para obtenção do EPGm e do IIN. A avaliação nutricional foi realizada por meio da Avaliação Subjetiva Global. Resultados: Foram avaliados 70 pacientes com idade média de 58,51±14,85 anos, dos quais 50 (71,5%) apresentaram algum grau de desnutrição, enquanto 27 (38,6%) apresentaram desnutrição grave. As categorias de risco do EPGm e do IIN estiveram presentes em 41 (58,6%) e 39 (55,7%) pacientes, respectivamente. O EPGm e o IIN associaram-se à presença da desnutrição (p<0,05). Conclusão: O EPGme o IIN mostraram-se ferramentas úteis, de fácil interpretação, com possibilidade de complementar a avaliação nutricional do paciente oncológico, uma vez que se associaram com a desnutrição.(AU)

Introduction: Malnutrition is a common finding in patients with cancer; its etiology is multifactorial and significantly influenced by the systemic inflammatory response. Inflammation indicators can be useful tools in the nutritional assessment of patients with cancer. Objective: We intended to evaluate the association of the modified Glasgow Prognostic Score (mGPS) and the InflammatoryNutritional Index (INI) with the presence and degree of malnutrition in cancer patients. Methods: We evaluated patients who were admitted to university hospital with a confirmed diagnosis of cancer participated in this study. Laboratory tests for albumin and C-reactive protein were conducted to obtain mGPS and INI scores. Nutritional assessment was carried out by subjective global assessment. Results: A total of 70 patients with a mean age of 58.51±14.85 years were evaluated, of which 50 (71.5%) presented some degree of malnutrition, while 27 (38.6%) presented severe malnutrition. The risk categories of mGPS and INI were present in 41 (58.6%) and 39 (55.7%) patients, respectively. Conclusion: Them GPS Score and the INI are simple tools, easy to interpret, with the possibility of complementing the nutritional evaluation of cancer patients, since they were associated with malnutrition.(AU)

Associação entre estado nutricional e Escore Prognóstico de Glasgow modificado em pacientes com câncer / Association between nutritional status and Score Glasgow Prognostic Score patients with the cancer

Introdução: A desnutrição é um achado comum em pacientes oncológicos e sua etiologia é multicausal, sendo influenciada significativamente pela resposta inflamatória sistêmica. Os indicadores de inflamação podem ser ferramentas úteis na avaliação nutricional dos pacientes com câncer. Objetivo: Avaliar a associação entre o estado nutricional e o Escore Prognóstico de Glasgow modificado (EPGm) em pacientes com câncer. Métodos: Pacientes admitidos em um hospital universitário, com diagnóstico confirmado de câncer, participaram deste estudo. Exames laboratoriais de albumina e proteína C-reativa (PCR) foram realizados para obtenção do EPGm. A avaliação nutricional foi realizada por meio da Avaliação Subjetiva Global (ASG), índice de massa corporal (IMC) e variáveis antropométricas. Resultados: Foram avaliados 70 pacientes com idade média de 58,51±14,85 anos, dos quais 50 (71,5%) apresentaram algum grau de desnutrição pela ASG, destes 27 (38,6%) apresentaram desnutrição grave. As categorias de risco do EPGm estiveram presentes em 41 (58,6%). O Escore Prognóstico de Glasgow modificado associou-se à presença da desnutrição (p<0,05). Conclusão: O Escore Prognóstico de Glasgow se associou ao estado nutricional definido pela Avaliação Subjetiva Global (AU)

Introduction: Malnutrition is a common finding in patients with cancer; its etiology is multifactorial and significantly influenced by the systemic inflammatory response. Inflammation indicators can be useful tools in the nutritional assessment of patients. Objective: To evaluate the association of the nutritional status with modified Glasgow Prognostic Score (mGPS) in cancer patients. Methods: We evaluated patients who were admitted to university hospital with a confirmed diagnosis of cancer participated in this study. Laboratory tests for albumin and C-reactive protein (CRP) were conducted to obtain mGPS scores. Nutritional assessment was carried out by subjective global assessment (SGA), body index massa (BMI) and anthropometric variables. Results: A total of 70 patients with a mean age of 58.51 ± 14.85 years were evaluated, of which 50 (71.5%) presented some degree of malnutrition, of these 27 (38.6%) presented severe malnutrition. The risk categories of mGPS was present in 41 (58.6%) patients. Conclusion: The modified Glasgow Prognostic Score was associated with the nutritional status defined by the Global Subjective Assessment (AU)

Thickness of the adductor pollicis muscle in nutritional assessment of surgical patients.

OBJECTIVE: To evaluate the correlation between thickness of the muscle adductor pollicis and anthropometric measurements, body mass index and Subjective Global Assessment in the nutritional assessment of surgical patients. METHODS: The study population comprised patients admitted to the general and reconstructive surgery unit of a university hospital in the city of Vitória (ES), Brazil. The inclusion criteria were patients evaluated in the first 48 hours of admission, aged ≥20 years, hemodynamically stable, with no edema or ascites. Data analysis was performed using the software Statistical Package for Social Science 21.0, significance level of 5%. RESULTS: The sample consisted of 150 patients that were candidates to surgery, mean age of 42.7±12.0 years. The most common reasons for hospitalization were surgical procedures, gastrintestinal diseases and neoplasm. Significant association was observed between thickness of adductor pollicis muscle and Subjective Global Assessment (p=0.021) and body mass index (p=0.008) for nutritional risk. Significant correlation was found between thickness of adductor pollicis muscle and arm muscle circumference, corrected arm muscle area, calf circumference and body mass index. There were no significant correlations between thickness of adductor pollicis muscle and triceps skinfold and age. CONCLUSION: The use of thickness of adductor pollicis muscle proved to be an efficient method to detect malnutrition in surgical patients and it should be added to the screening process of hospitalized patients, since it is easy to perform, inexpensive and noninvasive.

Thickness of the adductor pollicis muscle in nutritional assessment of surgical patients / Espessura do músculo adutor do polegar na avaliação nutricional de pacientes cirúrgicos

ABSTRACT Objective To evaluate the correlation between thickness of the muscle adductor pollicis and anthropometric measurements, body mass index and Subjective Global Assessment in the nutritional assessment of surgical patients. Methods The study population comprised patients admitted to the general and reconstructive surgery unit of a university hospital in the city of Vitória (ES), Brazil. The inclusion criteria were patients evaluated in the first 48 hours of admission, aged ≥20 years, hemodynamically stable, with no edema or ascites. Data analysis was performed using the software Statistical Package for Social Science 21.0, significance level of 5%. Results The sample consisted of 150 patients that were candidates to surgery, mean age of 42.7±12.0 years. The most common reasons for hospitalization were surgical procedures, gastrintestinal diseases and neoplasm. Significant association was observed between thickness of adductor pollicis muscle and Subjective Global Assessment (p=0.021) and body mass index (p=0.008) for nutritional risk. Significant correlation was found between thickness of adductor pollicis muscle and arm muscle circumference, corrected arm muscle area, calf circumference and body mass index. There were no significant correlations between thickness of adductor pollicis muscle and triceps skinfold and age. Conclusion The use of thickness of adductor pollicis muscle proved to be an efficient method to detect malnutrition in surgical patients and it should be added to the screening process of hospitalized patients, since it is easy to perform, inexpensive and noninvasive.

RESUMO Objetivo Avaliar a correlação entre a medida da espessura do músculo adutor do polegar com medidas antropométricas, índice de massa corporal e Avaliação Subjetiva Global no diagnóstico nutricional de pacientes cirúrgicos. Métodos Participaram do estudo pacientes internados em uma unidade de cirurgia geral e reparadora de um hospital universitário de Vitória (ES), Brasil. Os critérios de inclusão foram pacientes avaliados nas primeiras 48 horas de internação, idade ≥20 anos hemodinamicamente estáveis, sem edema ou ascite. A análise dos dados foi realizada pelo softwareStatistical Package for Social Science, versão 21.0, com nível de significância de 5%. Resultados Compuseram a amostra 150 pacientes candidatos à cirurgia, com média de idade de 42,7±12,0 anos. Os motivos de internação mais comuns foram procedimentos cirúrgicos, doenças do trato gastrointestinal e neoplasias. Observou-se associação significativa entre a espessura do músculo adutor do polegar com a Avaliação Subjetiva Global (p=0,021) e com o índice de massa corporal para risco nutricional (p=0,008). Foram encontradas correlações significativas entre a espessura do músculo adutor do polegar com circunferência muscular do braço, área muscular do braço corrigida, circunferência da panturrilha e índice de massa corporal. Não foram encontradas correlações significativas entre a espessura do músculo adutor do polegar com prega cutânea triciptal e idade. Conclusão O uso da espessura do músculo adutor do polegar mostrou-se um método eficiente na detecção de desnutrição em pacientes cirúrgicos e deve ser acrescentado ao processo de triagem de pacientes hospitalizados, uma vez que é de fácil execução, baixo custo e não invasivo.