Food Intake Visual Scale-A practical tool for assessing the dietary intake of hospitalized patients with decompensated cirrhosis.

BACKGROUND: The aim of this study was whether the Food Intake Visual Scale (FIVS) can be used in clinical practice to measure food intake in patients with decompensated cirrhosis. METHODS: A cross-sectional study was performed with patients with cirrhosis between April 2017 and July 2019. The food intake was assessed through the 1-day diet record (DR) and according to FIVS, which consists of pictures of four plates of food at different levels of consumption: "about all," "half," "a quarter," or "nothing." The analysis of variance test with Bonferroni multiple comparison analysis was used to compare the mean energy intake through the DR according to the FIVS categories. RESULTS: This study included 94 patients with a mean age of 60.29 ± 9.33 years. Patients with lower food intake according to the FIVS categories also had lower mean energy and macronutrient intake according to the DR: patients eating "about all" (n = 49, 52.1%) consumed a mean of 1526.58 ± 428.27 kcal/day, patients eating "half" (n = 16, 17%) consumed a mean of 1282.08 ± 302.83 kcal/day, patients eating "a quarter" (n = 25, 26.6%) consumed a mean of 978.96 ± 468.81 kcal/day, and patients eating "nothing" (n = 4, 4.3%) consumed a mean of 353.59 ± 113.16 kcal/day (P < .001). CONCLUSION: The results of this study demonstrate that FIVS can be implemented in clinical practice to measure food intake in patients with decompensated cirrhosis as a substitute for the DR because it is a noninvasive, low-cost, quick, reliable, and easy bedside method for obtaining data.

Phase Angle Is an Independent Predictor of 6-Month Mortality in Patients With Decompensated Cirrhosis: A Prospective Cohort Study.

BACKGROUND: This study aimed to evaluate the nutrition status through phase angle (PA) and its association with mortality in patients with decompensated cirrhosis. METHODS: A prospective cohort study was performed with hospitalized decompensated cirrhotic patients. Nutrition status was assessed by PA, bioelectrical impedance vector analysis (BIVA), and Subjective Global Assessment (SGA) within 72 hours of hospital admission. The best PA cutoff point for malnutrition diagnosis was determined by ROC curve analysis, considering the SGA as the reference standard. Predictors of 6-month mortality were identified using Cox proportional hazards models, adjusted for Child-Pugh and MELD scores, and hepatocellular carcinoma. RESULTS: This study included 97 patients, 63% male (n = 61), with a mean age of 60.1 ± 10.3 years. The median follow-up time of patients was 11.2 months (IQR, 2.4-21). Overall mortality was 58.8% (n = 57) and 6-month mortality was 35.1% (n = 34). Nutrition assessment according to BIVA indicated a risk for cachexia and normal hydration. Patients with values of PA ≤5.52° were considered malnourished. Malnourished patients according to PA (58.8%, n = 57) had a higher risk of 6-month mortality (HR = 3.44; 95% CI, 1.51-7.84; P = .003), and each increase of 1° in PA values was associated with a reduction of 53% in 6-month mortality risk. CONCLUSIONS: The PA is an independent predictor of 6-month mortality in patients with decompensated cirrhosis. Therefore, PA may be useful to assess the nutrition status and identify patients at the highest risk of mortality in clinical practice.

Fatores associados ao número de consultas pré-natais de mulheres tabagistas e não tabagistas atendidas em hospitais de Porto Alegre (RS), Brasil / Factors associated with the number of prenatal consultations of smokers and nonsmokers women answered in Porto Alegre hospitals, Brazil

Objetivo: analisar os fatores associados ao número de consultas pré-natais de mulheres tabagistas e não tabagistas. Métodos: análise transversal de uma amostra de conveniência de mulheres com histórias prévias de tabagismo e um grupo controle. A pesquisa foi aprovada pelos Comitês de Ética das instituições de origem. O desfecho foi o número de consultas pré-natais e as variáveis estudadas foram: idade materna (anos), raça (etnia), escolaridade (anos), renda familiar (reais), situação conjugal, número de filhos (prévios à gestação analisada) e o planejamento da gestação analisada. Os números de consultas prénatais foram comparados pelo teste MannWhitney. A regressão linear foi aplicada para avaliar o número de consultas prénatais e sua relação com as variáveis analisadas. Resultados: selecionaram-se 248 mulheres, distribuídas em controle (n=161) e tabagistas durante a gestação (n=87). Verificou-se que a mediana de idade foi 24 [20-30] anos e a escolaridade 9 [7,25-11] anos. A maioria das mulheres (71,4%) realizou mais de seis consultas pré-natais. Contatou-se maior frequência de mulheres solteiras no grupo tabagista (p=0,001). Tabagistas apresentaram menor escolaridade (p<0,0001), menor renda (p<0,0001), maior número de filhos (p=0,004), menor planejamento da gestação (p<0,0001) e menor número de consultas pré-natais (p<0,0001). O número de consultas pré-natais foi influenciado negativamente pelo tabagismo materno durante a gestação (p=0,009), pelo número de filhos (p<0,0001) e positivamente pela idade materna (p<0,0001). Conclusões: o tabagismo durante a gestação está associado a condições de maior vulnerabilidade socioeconômica, evidenciando a necessidade de um pré-natal adequado e cuidados mais intensos por profissionais de saúde para esta população.(AU)

Objective: To analyze the factors associated with the number of prenatal consultations of smokers and nonsmokers women. Methods: Cross-sectional analysis of a convenience sample of women with previous historic of smoking and a control group. The study was approved by the Ethics Committee of the institutions of origin. The outcome was the number of prenatal consultations and studied variables were: maternal age (in years), race (ethnicity), education (in years), family income (in reais), marital status, number of children (prior to the current analyzed pregnancy) and planning the current pregnancy. Prenatal consultations frequencies were compared by MannWhitney test. Linear regression was used to assess the number of prenatal consultations and its relation to the analyzed variables. Results: 248 women were selected, distributed in control (n=161) and smokers during pregnancy (n=87). It was found that the age median was 24 [20-30] years and the educational level was 9 [7.25 to 11] years. Most women (71.4%) performed more than six prenatal consultations. It was observed a higher frequency of single women among smoker mothers (p=0.001). Smoker mothers displayed lower education period (p<0.0001), lower familiar income (p<0.0001), higher number of children (p=0.004), lower planning pregnancy (p<0.0001) and fewer prenatal consultations (p<0.0001). The number of prenatal consultations was negatively influenced by maternal smoking (p=0.009), number of children (p<0.0001) and positively modulated by maternal age (p<0.0001). Conclusions: smoking during pregnancy is associated with conditions of greater socioeconomic vulnerability, demonstrating the need for adequate prenatal care and more intense care by health professional for this population.(AU)