Risco nutricional no período pré-operatório Nutritional risk in the preoperative period
RACIONAL: Prognóstico nutricional ruim no período pré-operatório -, principalmente nos pacientes que apresentam perda de peso -, pode levar à complicações pós-operatórias em maior frequência. OBJETIVO: Investigar indicadores de risco nutricional em pacientes internados em enfermaria de cirurgia, no período pré-operatório, estratificados por grupos de doenças mais frequentes no serviço. MÉTODO: Foram avaliados 512 pacientes portadores de abdome agudo, doenças do trato digestório, doenças de vias biliares, doenças ginecológicas, doenças vasculares, hérnias e traumas, sendo analisados o índice de massa corporal, a perda de peso recente, o consumo energético habitual, a contagem de linfócitos e o tempo de internação. Os dados foram comparados entre os grupos de doenças, sendo utilizado o teste qui-quadrado para a comparação de proporções ou teste exato de Fisher, quando necessário, com nível de significância de 5%. RESULTADOS: Os pacientes com trauma, seguidos daqueles portadores de doenças do trato digestório e abdome agudo, apresentaram índice de massa corporal mais baixos, com diferença significativa entre os grupos (P=0,0222), e entre os que mais apresentaram perda de peso recente na internação, estavam os pacientes com abdome agudo, (P=0,0048). Verificou-se maior percentual de depleção imunológica grave e moderada nos portadores de abdome agudo (P<0,0001) e, maior percentual de pacientes com consumo energético inferior a 1000 kcalorias, entre aqueles com doenças vasculares, (P=0,0311). Os pacientes com trauma apresentaram maior tempo de internação (P<0,0001). CONCLUSÃO: Os pacientes portadores de abdome agudo e trauma apresentaram maior risco nutricional no período pré-operatório, o que deveria demandar estratégias de atenção nutricional logo no início da internação.
BACKGROUND: Bad nutricional status in preoperative period - mainly associated to weight loss -, may lead to grater number of postoperative complications. AIM: To investigate the nutritional risk indicators in preoperative period, stratified by disease groups treated at the site. METHODS: A total of 512 patients with the following conditions were assessed: acute abdomen, digestive tract diseases, biliary diseases, gynecological diseases, vascular diseases, hernias and traumas. The following data were analyzed: body mass index, recent weight loss, habitual energy intake, lymphocyte count and length of hospital stay. The data were compared among the disease groups. The chi-square test or Fisher's exact test when necessary was used to compare proportions. The significance level was set at 5%. RESULTS: Trauma patients followed by those with digestive tract diseases and acute abdomen had significantly lower body mass index (P=0.0222), and the ones with acute abdomen presented recent weight loss at hospital admittance (P=0.0048). A greater percentage of severe and moderate immune depletion was seen in patients with acute abdomen (P<0.0001) and those with vascular diseases had a greater percentage of patients with energy intake below 1000 kcalories (P=0.0311). Trauma patients presented longer hospital stays (P<0.0001). CONCLUSION: Trauma and acute abdomen patients had greater nutritional risk during the preoperative period. Thus, nutritional care strategies should be oriented towards them since the hospital admittance.
BACKGROUND: Bad nutricional status in preoperative period - mainly associated to weight loss -, may lead to grater number of postoperative complications. AIM: To investigate the nutritional risk indicators in preoperative period, stratified by disease groups treated at the site. METHODS: A total of 512 patients with the following conditions were assessed: acute abdomen, digestive tract diseases, biliary diseases, gynecological diseases, vascular diseases, hernias and traumas. The following data were analyzed: body mass index, recent weight loss, habitual energy intake, lymphocyte count and length of hospital stay. The data were compared among the disease groups. The chi-square test or Fisher's exact test when necessary was used to compare proportions. The significance level was set at 5%. RESULTS: Trauma patients followed by those with digestive tract diseases and acute abdomen had significantly lower body mass index (P=0.0222), and the ones with acute abdomen presented recent weight loss at hospital admittance (P=0.0048). A greater percentage of severe and moderate immune depletion was seen in patients with acute abdomen (P<0.0001) and those with vascular diseases had a greater percentage of patients with energy intake below 1000 kcalories (P=0.0311). Trauma patients presented longer hospital stays (P<0.0001). CONCLUSION: Trauma and acute abdomen patients had greater nutritional risk during the preoperative period. Thus, nutritional care strategies should be oriented towards them since the hospital admittance.
Document Type: Research Article
Publication date: 01 January 2009
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