Clinical outcomes of elderly submitted to cardiac surgery in a hospital in the Federal District and its relationship with nutritional status
Desfechos clínicos de idosos submetidos à cirurgia cardíaca em um hospital de referência do Distrito Federal e sua relação com o estado nutricional
Palavras-chave:
Aged, Nutritional assessment, Nutritional status, Heart failureResumo
Introduction: Aging is a worldwide event, which leads to numerous systemic changes, with repercussions on the nutritional status and general health of the elderly. Objective: to correlate clinical outcomes with nutritional status determined by subjective and objective methods in elderly patients submitted to cardiac surgery. Methods: This is a prospective cohort study performed at the Federal District Cardiology Institute, from February to July 2018. The patients were evaluated in the pre- and postoperative phases with the subjective methods and objective. Results: the sample consisted of 84 (94.38%) patients. We observed a significant reduction (p<0,001) in weight, CB and PPF in the postoperative period when compared to preoperative cardiac surgery. There was no association of the outcome (discharge or death) with the nutritional risk determined by the NRS-2002 method. Patients who died had a longer CPB time. Conclusion: The was a lack of correlation between clinical outcomes and nutritional status. The high CPB time had a negative impact on the outcome of the elderly patients.
Downloads
Referências
BARBOSA-SILVA, T.G., BIELEMANN, R.M., GONZALEZ, M.C., et al. Prevalence of sarcopenia among community-dwelling elderly of a medium-sized South American city: Results of the COMO VAI? Study. J Cachexia Sarcopenia Muscle. v.7, n.2, p.136-43, 2016. DOI: 10.1002/jcsm.12049.
BONILLA-PALOMAS, J.L., GÁMEZ-LÓPEZ, A.L., CASTILLO-DOMÍNGUEZ, J.C., et al. Nutritional Intervention in Malnourished Hospitalized Patients with Heart Failure. Arch Med Res. v.47, n.7, p.535-540, 2016. DOI: 10.1016/j.arcmed.2016.11.005.
COELHO, P., RODRIGUES, V., MIRANDA, L., et al. Servic Do prices reflect the costs of cardiac surgery in theelderly? Rev Port Cardiol. v.36, n.1, p.35-41, 2017. DOI: 10.1016/j.repc.2016.08.006.
DUARTE, A.C., CASTELLANI, F.R. Semiologia nutricional. 1. ed. Axcel Books. Rio de Janeiro. 2002, p.115.
GOLDFARB, M., LAUCK, S., WEBB, J.G., et al. Malnutrition and Mortality in Frail and Non-Frail Older Adults Undergoing Aortic Valve Replacement. Circulation, v.138, n.20, p.2202-11, 2018. DOI: 10.1161/CIRCULATIONAHA.118.033887
GONÇALVES, L.B., JESUS, N.M.T., GONÇALVES, M.B. et al. Preoperative Nutritional Status and Clinical Complications in the Postoperative Period of Cardiac Surgeries. Brazilian Journal of Cardiovascular Surgery, v.31, n.5, p.371-380, 2016. DOI: 10.5935/1678-9741.20160077.
HONDA, Y, NAGAI, T, IWAKAMI, N, et al. Usefulness of Geriatric Nutritional Risk Index for Assessing Nutritional Status and Its Prognostic Impact in Patients Aged ≥ 65 Years With Acute Heart Failure. Am J Cardiol, v.118, n.4, p.550–555, 2016. DOI: 10.1016/j.amjcard.2016.05.045
HSU, W.C., TSAI, A.C., WANG, J.Y. Calf circumference is more effective than body mass index in predicting emerging care-need of older adults – results of a national cohort study. Clinical Nutrition, v.35, p.735-40, 2016. DOI:10.1016/j.clnu.2015.05.017.
JAMES, R. Nutritional support in alcoholic liver disease: a review. Journal of Human Nutrition and Dietetics, v.2, p.315-323, 1989. DOI:10.1111/j.1365-277X.1989.tb00034.x.
KONDRUP, J., ALLISON, S.P., ELIA, M., et al. ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr. v.22, n.4, p.415-421, 2003. DOI:10.1016/S0261-5614(03)00098-0.
KRUIZENGA, H., VAN KEEKEN, S., WEIJS, P., et al. Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. Am J Clin Nutr., 2016:126615. DOI: 10.3945/ajcn.115.126615.
KUCZMARSKI, M.F., KUCZARISK, R.J., NAJJAR, M. Descriptive anthropometric reference data for older Americans. J Am Diet Assoc. v.100, p.59-66, 2000. DOI: 10.1016/S0002-8223 (00) 00021-3.
LEANDRO-MERHI, V.A., BRÁZ, V.N., AQUINO, J.L.B. Is total lymphocyte count related to nutritional markers in hospitalized older adults? Arq Gastroenterol., v.54, n.1, p.79-82, 2017.
LENARDT, M.H., BINOTTO, M.A., CARNEIRO, N.H.K., et al. Força de preensão manual e atividade física em idosos fragilizados. Rev Esc Enferm USP. v.50, n.1, p.88-94, 2016. DOI: 10.1590/S0080-623420160000100012.
LIPSCHITZ, D.A. Screening for nutritional status in the elderly. Prim Care. v.21, n.1, p.55-67, 1994.
MARTINEZ, B.P., RAMOS, I.R., OLIVEIRA, Q.C. Existe associação entre massa e força muscular esquelética em idosos hospitalizados? Rev. Bras. Geriatr. Gerontol. v.19, n.2, p.257-264, 2016. DOI: 10.1590/1809-98232016019.140228.
MINISTÉRIO DA SAÚDE (MS). Orientações para coleta e análise de dados antropométricos em serviços de saúde: norma técnica do sistema de Vigilância Alimentar e Nutricional - SISVAN. Brasília: Ministério da Saúde, 2011. Disponível em: <http://dab.saude.gov.br/portaldab/biblioteca.php?conteudo=publicacoes/orientacoes_coleta_analise_dados_antropometricos>. Acesso em: 09/02/2024.
NUNES, P.P., MARSHALL, N.G. Nutritional Risk Screening (NRS 2002) como instrumento preditor de desfechos pós-operatórios em pacientes submetidos a cirurgias gastrointestinais. Rev Bras Nutr Clin., v.30, n.2, p.120-5, 2015.
POURHASSAN, M., BÖTTGER, S., JANSSEN, G., et al. The Association of Inflammation with Food Intake in Older Hospitalized Patients. J Nutr Health Aging. v.22, n.5, p.589-593, 2018. DOI: 10.1007/s12603-017-0976-2.
RINGAITIENĖ, D., GINEITYTĖ, D., VICKA, V., et al. Impact of malnutrition on postoperative delirium development after on pump coronary artery bypass grafting. Journal of Cardiothoracic Surgery, v.10, n.74, p.1-7, 2015. DOI: 10.1186/s13019-015-0278-x.
RUBENSTEIN, L.Z., HARKER, J.O., SALVA, A., et al. Screening for undernutrition in geriatric practice: developing the short-form Mini-Nutritional Assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. v.56, p.366-72, 2001. DOI: 10.1093/gerona/56.6.M366.
SANTOS, N.F.D., PINHO, C.P.S., CARDOSO, A.J.P.F., et al. Cachexia in hospitalized patients with heart failure. Nutr Hosp. v.35, n.3, p.669-676, 2018. DOI: 10.20960/nh.1390.
SILVEIRA, C.R, BOGADO, M., SANTOS, K., et al. Desfechos clínicos de pacientes submetidos à cirurgia cardíaca em um hospital do noroeste do Rio Grande do Sul. Rev. Enferm. UFSM, v.6, n.1, p.102-111, 2016. DOI: 10.5902/2179769216467.
SLEE, A, BÉTULA, D, STOKOE, D. A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients. Clin Nutr., v.34, n.2, p.296-301, 2015. DOI: 10.1016/j.clnu.2014.04.013.
SORENSEN, J., KONDRUP, J., PROKOPOWICZ, J., et al. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr. 2008; v.27, n.3, p.340-9, 2008. DOI: 10.1016/j.clnu.2008.03.012.
TODOROVIC, V., RUSSELL, C., STRATTON, R., et al. The ‘MUST’ Explanatory Booklet: A Guide to the ‘Mulnutrition Universal Screenung Tool’ (MUST) for Adults. Redditch: Malnutrition Advisory Group (MAG) Standing Committee of the British Association for Parenteral and Enteral Nutrition (BAPEN); 2011. Disponível em: <http://www.bapen.org.uk/pdfs/must/must_explan.pdf>. Acesso em: 09/02/2024.
WORLD HEALTH ORGANIZATION (WHO). Cardiovascular diseases (CVDs). Disponível em: <http://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)> Acesso em: 18/07/2018.