Formulas alimentares: influência no estado nutricional, condição clínica e complicações na terapia nutricional domiciliar / Nutrition formulas: influence on nutritional condition, clinical condition and complications in household nutrition therapy

Introdução: As transições demográfica, epidemiológica e nutricional contribuem para o aumento do nú- mero de indivíduos com necessidade de Terapia Nutricional Enteral Domiciliar (TNED). Objetivo: Analisar a influência da categoria de fórmula nutricional no estado nutricional, nas complica- ções relacionadas à TNED e na necessidade de hospitalização de indivíduos em TNED. Métodos: Estudo clínico transversal observacional analítico realizado em Curitiba, PR, Brasil, com adultos e idosos em TNED. A antropometria, a categoria de fórmula alimentar infundida, a presença de complica- ções relacionadas à TNED e a necessidade de admissão hospitalar foram avaliadas. O estado nutricional foi classificado por meio do Índice de Massa Corporal (IMC). A estatística foi descritiva e as análises dos dados foi realizada por teste de qui-quadrado ou teste exato de Fisher e teste de Kruskal Wallis. O nível de significância adotado foi de 5% (p0,05). Discussão: Estudos sugerem que estado nutricional, complicações relacionadas à TNED e necessidade de hospitalização dependem da categoria de fórmula utilizada. Os resultados do presente estudo demonstraram que a categoria de fórmula não influencia o estado nutricional e admissões hospitalares. Conclusão: A categoria de fórmula não influencia no estado nutricional, presença de complicações e readmissões hospitalares. O estado nutricional comprometido não aumentou a ocorrência de complicações relacionadas à TNED e a necessidade de hospitalização (AU)

Introduction: Demographic, epidemiologic and nutritional transitions have contributed to increase Home Enteral Nutrition (HEN). Objective: To analyze the influence of enteral nutrition type in nutritional status, outcome related with HEN and need of hospital care. Method: Clinical cross-sectional, observational and analytical study in Curitiba, PR, Brazil, with adults and elders in HEN. Anthropometric data, diet enteral nutrition type, outcomes related with HEN and need of hospital care were assessed. Body Mass Index (BMI) classified nutritional status. Data were analyzed in descriptive and statistic way (chi-square, Fischer test and Kruskal Wallis test). Results: The final sample was 42 patients. Most of the participants was older than 60 years (mean age: 65y; minimum: 21y; maximum: 94y), 50% (n=21) of each sex. Undernutrition was observed in 72.7% and 86.2%, to adults and elders, respectively. Hospital care was needed by 72.8% and, industrialized and food blended enteral nutrition used concomitantly was observed to 57.1% of the patients. Gastrointestinal system outcomes were the most frequent (40.5%) and tube obstruction frequency was higher in food blended HEN. There were no association between nutritional status with outcomes and diet enteral nutrition type (p>0.05). Discussion: Studies suggested that nutritional status, outcome related with HEN and need of hospital care depends on HEN formula type, and these results are different from ours. HEN formula type did not influence nutritional status and need of hospital care. Conclusion: HEN formula type did not influence nutritional status, outcomes, and in need of hospital care. Nutritional status did not influence outcomes related with HEN, and in need of hospital care (AU)

O índice de risco nutricional (nutritional risk index) é preditor de complicação pós-operatória em operações do aparelho digestivo ou parede abdominal? / Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

RACIONAL: Pode-se considerar a desnutrição como doença mais comum no ambiente hospitalar, devido à sua alta prevalência. OBJETIVO: Verificar os indicadores de estado nutricional que melhor se correlacionam com as complicações pós-operatórias e o tempo de permanência hospitalar de pacientes submetidos à operações do aparelho digestivo ou parede abdominal de médio e grande porte. MÉTODO: Estudo retrospectivo, com análise de 215 fichas de avaliação nutricional de pacientes cirúrgicos que foram submetidos à avaliação nutricional por meio de dados antropométricos (peso, altura, IMC, circunferência do braço, prega cutânea triciptal, circunferência muscular do braço), avaliação subjetiva global e dados bioquímicos (contagem total de linfócitos e albumina sérica). Em adição, posteriormente foi calculado o índice de risco nutricional. RESULTADOS: Foram incluídos 125 indivíduos. Diagnóstico de desnutrição de acordo com circunferência muscular do braço, índice de risco nutricional e avaliação subjetiva global foi de 46%, 88% e 66%, respectivamente. A classificação como gravemente desnutridos foi de 17,6% dos pacientes de acordo com a avaliação subjetiva global, enquanto que com o índice de risco nutricional foi de 42%. Os pacientes com câncer são mais desnutridos (5,42 unidades do índice de risco nutricional a menos). Houve correlação significativa entre ocorrência de complicações pós-operatórias não infecciosas quando analisado o índice de risco nutricional, considerando que seus menores complicaram mais (p=0,0016). O mesmo resultado foi obtido para albumina sérica (p=0,0015). Os pacientes sem complicações permaneceram, em média, 14,24 dias internados a menos do que os pacientes com complicações não infecciosas (p<0,05). CONCLUSÃO: O índice de risco nutricional e a albumina sérica são os parâmetros com melhor capacidade em predizer ocorrência de complicações pós-operatórias não infecciosas.

BACKGROUND: Malnutrition can be considered the most common disease in hospitals due to its high prevalence. AIM: To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. METHODS: This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. RESULTS: A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05). CONCLUSION: Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.

Nutritional risk index is predictor of postoperative complications in operations of digestive system or abdominal wall?

BACKGROUND: Malnutrition can be considered the most common disease in hospitals due to its high prevalence. AIM: To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries. METHODS: This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated. RESULTS: A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05). CONCLUSION: Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.