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1.
Nutr Hosp ; 34(5): 1390-1398, 2017 Sep 14.
Artigo em Espanhol | MEDLINE | ID: mdl-29280656

RESUMO

OBJECTIVE: The main objective has been to evaluate and quantify the prevalence of malnutrition at admission, the degree of severity and the correlation with the nutritional parameters in a basic general hospital of the first level. METHODS: Observational, transverse, and randomized study of 244 patients (59.8% male and 40.2% female) performed during the first 24 hours of hospital admission and with a nutritional assessment including nutritional screening (CONUT®), anthropometric parameters, other analytical parameters and a quantification of hospital stay. RESULTS: In this study, 60.7% of the sample has at least one criterion of malnutrition (anthropometric and/or analytical). When considering at least two altered nutritional parameters (one of them analytical type), the prevalence was 29.1%. Prealbumin and transferrin have been shown to be particularly sensitive to moderate to severe and mild malnutrition, respectively. CONUT® has detected nutritional risk of a mild nature in 39.8%. Malnourished patients have a longer stay, and are statistically significant in oncological versusnon-oncological patients. CONCLUSIONS: Anthropometric parameters, on their own, can generate some degree of controversy over the prevalence of malnutrition, so it is considered as appropriate to use two parameters, at least one of an analytical type. Prealbumin is the most sensitive and specific indicator, and CONUT® is an easy, quick and economical tool for nutritional screening. In order to greatly alleviate malnutrition at hospital admission, the objective of the study, it would be wise to strengthen its screening and treatment from Primary Health Care.


Assuntos
Renda , Desnutrição/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , Feminino , Hospitais Gerais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Prevalência
2.
Nutr. hosp ; 34(6): 1390-1398, nov.-dic. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-168980

RESUMO

Objetivo: nuestro objetivo principal ha sido evaluar y cuantificar la prevalencia de desnutrición al ingreso, su grado de severidad y su correlación con parámetros nutricionales en un hospital general básico de primer nivel. Métodos: estudio observacional, transversal y aleatorio sobre 244 pacientes (59,8% hombres y 40,2% mujeres), realizado durante las primeras 24 horas del ingreso hospitalario y con una valoración nutricional que incluyó cribado nutricional (CONUT®), parámetros antropométricos, otros parámetros analíticos y una cuantificación de la estancia hospitalaria. Resultados: el 60,7% de la muestra presenta al ingreso algún criterio de desnutrición (antropométrico y/o analítico). Cuando se han considerado al menos dos parámetros nutricionales alterados (uno de ellos de tipo analítico), la prevalencia ha sido del 29,1%. La prealbúmina y la transferrina se han mostrado especialmente sensibles frente a la desnutrición moderada-grave y leve respectivamente. CONUT® ha detectado riesgo nutricional de carácter leve en el 39,8%. Los pacientes desnutridos tienen una estancia más prolongada, que es estadísticamente significativa en los oncológicos frente a los no oncológicos. Conclusiones: los parámetros antropométricos, por sí solos, pueden generar algún grado de controversia sobre la prevalencia de la desnutrición, por lo que se considera adecuado utilizar dos parámetros, al menos uno de tipo analítico. La prealbúmina se nos presenta como el indicador más sensible y específico y el CONUT®, como una herramienta fácil, rápida y económica para el cribado nutricional. Para mitigar en gran medida la desnutrición al ingreso hospitalario, objetivo del estudio, sería acertado potenciar su cribado y tratamiento desde Atención Primaria (AU)


Objective: The main objective has been to evaluate and quantify the prevalence of malnutrition at admission, the degree of severity and the correlation with the nutritional parameters in a basic general hospital of the first level. Methods: Observational, transverse, and randomized study of 244 patients (59.8% male and 40.2% female) performed during the first 24 hours of hospital admission and with a nutritional assessment including nutritional screening (CONUT®), anthropometric parameters, other analytical parameters and a quantification of hospital stay. Results: In this study, 60.7% of the sample has at least one criterion of malnutrition (anthropometric and/or analytical). When considering at least two altered nutritional parameters (one of them analytical type), the prevalence was 29.1%. Prealbumin and transferrin have been shown to be particularly sensitive to moderate to severe and mild malnutrition, respectively. CONUT® has detected nutritional risk of a mild nature in 39.8%. Malnourished patients have a longer stay, and are statistically significant in oncological versus non-oncological patients. Conclusions: Anthropometric parameters, on their own, can generate some degree of controversy over the prevalence of malnutrition, so it is considered as appropriate to use two parameters, at least one of an analytical type. Prealbumin is the most sensitive and specific indicator, and CONUT® is an easy, quick and economical tool for nutritional screening. In order to greatly alleviate malnutrition at hospital admission, the objective of the study, it would be wise to strengthen its screening and treatment from Primary Health Care (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Hospitalização/estatística & dados numéricos , Desnutrição/epidemiologia , Valor Nutritivo/fisiologia , Avaliação Nutricional , Atenção Primária à Saúde , Hospitais Gerais , Estudos Transversais/métodos , Tempo de Internação/estatística & dados numéricos , Antropometria/métodos , 28599
3.
Nutr Hosp ; 34(1): 73-80, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28244775

RESUMO

BACKGROUND: Reducing the dietary glycaemic response has been proposed as a way to reduce the risk of diabetes complications. OBJECTIVE: The aim of the present study was to evaluate the glycaemic control and cardiovascular risk biomarkers in fragile, elderly type 2 diabetes patients after the intake of a new fructose-free diabetes-specific formula enriched with resistant-starch type IV and high in monounsaturated fatty acids. METHODS: Forty-one type 2 diabetes patients aged 78.9 ± 2.8 years were fed exclusively with an enteral diabetes-specific formula for 6 weeks. Data were collected at baseline and after 6 weeks of feeding. Carbohydrate and lipid metabolism and inflammatory and cardiovascular risk biomarkers were measured to evaluated the course of diabetes complications. RESULTS: Blood glycated haemoglobin significantly decreased after the intervention (6.1 ± 0.1 vs. 5.8 ± 0.1 %; p< 0,045), as well as monocyte chemotactic protein-1 and soluble E-selectin (p < 0.05), while soluble vascular cell adhesion molecule and plasminogen activator inhibitor-1 tended to decrease from baseline to 6 weeks (p = 0.084 and p = 0.05, respectively). CONCLUSION: The new product improves glycaemic control and cardiovascular risk without altering lipid metabolism, which is useful for the prevention of diabetic complications. Longer intervention studies are needed in order to validate these results in a larger population.


Assuntos
Biomarcadores/análise , Glicemia/análise , Doenças Cardiovasculares/epidemiologia , Alimentos Formulados/análise , Amido/análise , Idoso , Idoso de 80 Anos ou mais , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Nutrição Enteral , Feminino , Frutose/análise , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
4.
Nutr. hosp ; 34(1): 73-80, ene.-feb. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-161144

RESUMO

Background: Reducing the dietary glycaemic response has been proposed as a way to reduce the risk of diabetes complications. Objective: The aim of the present study was to evaluate the glycaemic control and cardiovascular risk biomarkers in fragile, elderly type 2 diabetes patients after the intake of a new fructose-free diabetes-specific formula enriched with resistant-starch type IV and high in monounsaturated fatty acids. Methods: Forty-one type 2 diabetes patients aged 78.9 ± 2.8 years were fed exclusively with an enteral diabetes-specific formula for 6 weeks. Data were collected at baseline and after 6 weeks of feeding. Carbohydrate and lipid metabolism and inflammatory and cardiovascular risk biomarkers were measured to evaluated the course of diabetes complications. Results: Blood glycated haemoglobin significantly decreased after the intervention (6.1 ± 0.1 vs. 5.8 ± 0.1 %; p < 0,045), as well as monocyte chemotactic protein-1 and soluble E-selectin (p < 0.05), while soluble vascular cell adhesion molecule and plasminogen activator inhibitor-1 tended to decrease from baseline to 6 weeks (p = 0.084 and p = 0.05, respectively). Conclusion: The new product improves glycaemic control and cardiovascular risk without altering lipid metabolism, which is useful for the prevention of diabetic complications. Longer intervention studies are needed in order to validate these results in a larger population (AU)


Introducción: el control de la respuesta glucémica se ha propuesto como un mecanismo útil para reducir el riesgo de las complicaciones en los diabéticos. Objetivo: evaluar el efecto sobre el control glucémico y el riesgo cardiovascular en ancianos con diabetes de tipo 2 de una nueva fórmula específica para diabéticos, sin fructosa, y que contiene almidones resistentes de tipo IV y un elevado contenido en ácidos grasos monoinsaturados. Métodos: 41 pacientes con diabetes mellitus de tipo 2 y una edad media de 78,9 ± 2,8 años se alimentaron exclusivamente de forma enteral con la fórmula específica para diabéticos durante 6 semanas. Se tomaron muestras al inicio y al final del periodo de intervención y se determinaron biomarcadores del metabolismo de los carbohidratos y lípidos, así como de inflamación y riesgo cardiovascular, con objeto de evaluar el curso de las complicaciones de la diabetes. Resultados: la hemoglobina glicosilada en la sangre disminuyó de forma significativa tras la intervención (6,1 ± 0,1 vs. 5,8 ± 0,1 %; p < 0,045), así como la proteína quimiotáctica de monocitos-1 y la E-selectina soluble (p < 0,05), mientras que la molécula de adhesión vascular y el activador del plasminógeno-1 tendieron a disminuir tras las 6 semanas de intervención (p = 0,084 y p = 0,05, respectivamente). Conclusión: el nuevo producto mejora el control glucémico y el riesgo cardiovascular sin alterar el metabolismo lipídico, lo que resulta útil para la prevención de las complicaciones de los diabéticos. Se necesitan estudios más prolongados para confirmar este efecto en una población más amplia (AU)


Assuntos
Humanos , Idoso , Diabetes Mellitus Tipo 2/dietoterapia , Dieta com Restrição de Carboidratos , Doenças Cardiovasculares/prevenção & controle , Nutrição Enteral/métodos , Hiperglicemia/prevenção & controle , Complicações do Diabetes/prevenção & controle , Dieta para Diabéticos/métodos , Biomarcadores/análise , Frutose/análise , Fatores de Risco , Alimentos Fortificados
5.
Nutr Hosp ; 32(1): 389-93, 2015 Jul 01.
Artigo em Espanhol | MEDLINE | ID: mdl-26262744

RESUMO

BACKGROUND: one of the methods of diagnosis of malnutrition is serum albumin, for the simplicity of its determination and low cost. OBJECTIVES: the main objective is to validate and implement a computer program based on the determination of serum albumin, allowing early detection and treatment to malnourished or at risk of malnutrition patients, still another objective evaluation of costs by diagnosis-related groups. METHODS: the study design is cohort, dynamic and prospective, which are included hospital discharge from november 2012 until march 2014, being the study population of patients over age 14 who enter the various services of a Medical Surgical Hospital of the Granada's Hospital Complex Univesity, whose numbers are lower serum albumin 3.5 g/dL, for a total of 307 patients. RESULTS: of the 307 patients, 141 are malnourished (program sensitivity: 45.9%). 54.7% of patients were male and 45.3% female. The mean age of 65.68 years. The median length of stay is 16 days. 13.4% of patients have died. The average cost of GRD is € 5 958.30 and said average cost after detecting malnutrition is € 11 376.48. CONCLUSIONS: the algorithm that implements the software identifies nearly half of patients hospitalized malnourished. It is essential to record the diagnosis of malnutrition.


Introducción: uno de los métodos de diagnóstico de la desnutrición es la albúmina sérica, por la sencillez de su determinación y bajo coste. Objetivos: el objetivo principal es validar e implementar un programa informático, basado en la determinación de albúmina sérica, que permita detectar y tratar precozmente a los pacientes desnutridos o en riesgo de desnutrición, siendo otro objetivo la evaluación de costes por grupos relacionados por el diagnóstico. Métodos: el diseño del estudio es de tipo cohorte, dinámico y prospectivo, en el que se han incluido las altas hospitalarias desde noviembre del año 2012 hasta marzo del año 2014, siendo la población de estudio los pacientes mayores de 14 años que ingresen en los diversos servicios de un Hospital Médico Quirúrgico del Complejo Hospitalario Universitario de Granada, cuyas cifras de albúmina sérica sean menores de 3,5 g/dL, siendo el total de 307 pacientes. Resultados: de los 307 pacientes, 141 presentan desnutrición (sensibilidad del programa: 45,9%). El 54,7% de los pacientes son hombres y el 45,3% mujeres. La edad media es de 65,68 años. La mediana de la estancia es de 16 días. El 13,4% de los pacientes han fallecido. El coste medio de los GRD es de 5.958,30 € y dicho coste medio después de detectar la desnutrición es de 11.376,48 €. Conclusiones: el algoritmo que implementa el programa informático identifica a casi la mitad de los pacientes hospitalizados desnutridos. Es fundamental registrar el diagnóstico de desnutrición.


Assuntos
Custos Hospitalares , Hospitalização , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Software , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Desnutrição/mortalidade , Pessoa de Meia-Idade , Avaliação Nutricional , Estudos Prospectivos , Espanha/epidemiologia
6.
Nutr. hosp ; 32(1): 389-393, jul. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-141384

RESUMO

Introducción: uno de los métodos de diagnóstico de la desnutrición es la albúmina sérica, por la sencillez de su determinación y bajo coste. Objetivos: el objetivo principal es validar e implementar un programa informático, basado en la determinación de albúmina sérica, que permita detectar y tratar precozmente a los pacientes desnutridos o en riesgo de desnutrición, siendo otro objetivo la evaluación de costes por grupos relacionados por el diagnóstico. Métodos: el diseño del estudio es de tipo cohorte, dinámico y prospectivo, en el que se han incluido las altas hospitalarias desde noviembre del año 2012 hasta marzo del año 2014, siendo la población de estudio los pacientes mayores de 14 años que ingresen en los diversos servicios de un Hospital Médico Quirúrgico del Complejo Hospitalario Universitario de Granada, cuyas cifras de albú- mina sérica sean menores de 3,5 g/dL, siendo el total de 307 pacientes. Resultados: de los 307 pacientes, 141 presentan desnutrición (sensibilidad del programa: 45,9%). El 54,7% de los pacientes son hombres y el 45,3% mujeres. La edad media es de 65,68 años. La mediana de la estancia es de 16 días. El 13,4% de los pacientes han fallecido. El coste medio de los GRD es de 5.958,30€ y dicho coste medio después de detectar la desnutrición es de 11.376,48€. Conclusiones: el algoritmo que implementa el programa informático identifica a casi la mitad de los pacientes hospitalizados desnutridos. Es fundamental registrar el diagnóstico de desnutrición (AU)


Background: one of the methods of diagnosis of malnutrition is serum albumin, for the simplicity of its determination and low cost. Objectives: the main objective is to validate and implement a computer program based on the determination of serum albumin, allowing early detection and treatment to malnourished or at risk of malnutrition patients, still another objective evaluation of costs by diagnosis-related groups. Methods: the study design is cohort, dynamic and prospective, which are included hospital discharge from november 2012 until march 2014, being the study population of patients over age 14 who enter the various services of a Medical Surgical Hospital of the Granada´s Hospital Complex Univesity, whose numbers are lower serum albumin 3.5 g/dL, for a total of 307 patients. Results: of the 307 patients, 141 are malnourished (program sensitivity: 45.9%). 54.7% of patients were male and 45.3% female. The mean age of 65.68 years. The median length of stay is 16 days. 13.4% of patients have died. The average cost of GRD is €5 958.30 and said average cost after detecting malnutrition is €11376.48. Conclusions: the algorithm that implements the software identifies nearly half of patients hospitalized malnourished. It is essential to record the diagnosis of malnutrition (AU)


Assuntos
Humanos , Diagnóstico por Computador/métodos , Desnutrição/diagnóstico , Hospitalização/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Diagnóstico Precoce , Grupos Diagnósticos Relacionados
7.
Nutr. hosp ; 28(4): 1274-1279, jul.-ago. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-120309

RESUMO

Introducción: La desnutrición constituye uno de los principales problemas de Salud Pública, según datos de la OMS, es la primera causa de mortalidad, cuando la misma afecta al colectivo de los sujetos hospitalizados, toma entidad propia denominándose “desnutrición hospitalaria”. Objetivos: El objetivo general es cuantificar los diagnósticos principales de alta más frecuentes, que causan exitus, con el diagnóstico secundario de desnutrición. Métodos: Se trata de un estudio transversal y descriptivo, en el que se han incluido todas las altas hospitalarias del año 2011 y primer semestre de 2012, que han sido exitus y que tienen como diagnóstico secundario la desnutrición, siendo el total de 33. Se ha realizado un análisis estadístico descriptivo, efectuándose el test de Mann-Whitney para pruebas no paramétricas (p < 0,05). Resultados: Los diagnósticos principales más frecuentes entre las 33 altas analizadas son la sepsis (12,1%), metástasis hepáticas (9,1%), neumonía (6,1%), insuficiencia respiratoria aguda (6,1%) e insuficiencia renal aguda (6,1%). Conclusiones: Aunque el diagnóstico principal más frecuente es la sepsis, al agrupar los diagnósticos, el GRD más frecuente es de patología respiratoria, por lo que se ha de hacer codificación exhaustiva y de calidad para ajustar el peso relativo de los mismos a la realidad. Es fundamental especificar en la fuente de información clínica utilizada para la codificación, el grado de desnutrición, para obtener mayor especificidad en los datos (AU)


BACKGROUND: Malnutrition is a major public health problems, according to WHO, is the leading cause of death, when it affects the group of hospitalized patients, making denominating separate entity "hospital malnutrition". OBJECTIVES: The overall objective is to quantify the main diagnoses frequently high, causing exitus, with secondary diagnosis of malnutrition. METHODS: This is a descriptive study, which included all hospital discharges in 2011 and first half of 2012, which have been exitus and whose secondary diagnosis of malnutrition, with the total of 33. We performed a descriptive analysis, effected the Mann-Whitney nonparametric test (p < 0.05).RESULTS: The most frequent main diagnoses among 33 analyzed are high sepsis (12.1%), liver metastases (9.1%), pneumonia (6.1%), acute respiratory failure (6.1%) and renal acute renal (6.1%).CONCLUSIONS: Although the most frequent primary diagnosis of sepsis, by grouping the diagnoses, the most frequent DRG is respiratory disease, so it has to make comprehensive and quality coding to adjust the relative weight of the same reality. It is essential to specify the source of clinical information used for coding, the degree of malnutrition, for greater specificity in the data (AU)


Assuntos
Humanos , Mortalidade Hospitalar , Desnutrição/epidemiologia , /estatística & dados numéricos , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Causas de Morte
8.
Nutr Hosp ; 28(4): 1274-9, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23889652

RESUMO

BACKGROUND: Malnutrition is a major public health problems, according to WHO, is the leading cause of death, when it affects the group of hospitalized patients, making denominating separate entity "hospital malnutrition". OBJECTIVES: The overall objective is to quantify the main diagnoses frequently high, causing exitus, with secondary diagnosis of malnutrition. METHODS: This is a descriptive study, which included all hospital discharges in 2011 and first half of 2012, which have been exitus and whose secondary diagnosis of malnutrition, with the total of 33. We performed a descriptive analysis, effected the Mann-Whitney nonparametric test (p < 0.05). RESULTS: The most frequent main diagnoses among 33 analyzed are high sepsis (12.1%), liver metastases (9.1%), pneumonia (6.1%), acute respiratory failure (6.1%) and renal acute renal (6.1%). CONCLUSIONS: Although the most frequent primary diagnosis of sepsis, by grouping the diagnoses, the most frequent DRG is respiratory disease, so it has to make comprehensive and quality coding to adjust the relative weight of the same reality. It is essential to specify the source of clinical information used for coding, the degree of malnutrition, for greater specificity in the data.


Introducción: La desnutrición constituye uno de los principales problemas de Salud Pública, según datos de la OMS, es la primera causa de mortalidad, cuando la misma afecta al colectivo de los sujetos hospitalizados, toma entidad propia denominándose "desnutrición hospitalaria". Objetivos: El objetivo general es cuantificar los diagnósticos principales de alta más frecuentes, que causan exitus, con el diagnóstico secundario de desnutrición. Métodos: Se trata de un estudio transversal y descriptivo, en el que se han incluido todas las altas hospitalarias del año 2011 y primer semestre de 2012, que han sido exitus y que tienen como diagnóstico secundario la desnutrición, siendo el total de 33. Se ha realizado un análisis estadístico descriptivo, efectuándose el test de Mann-Whitney para pruebas no paramétricas (p < 0,05). Resultados: Los diagnósticos principales más frecuentes entre las 33 altas analizadas son la sepsis (12,1%), metástasis hepáticas (9,1%), neumonía (6,1%), insuficiencia respiratoria aguda (6,1%) e insuficiencia renal aguda (6,1%). Conclusiones: Aunque el diagnóstico principal más frecuente es la sepsis, al agrupar los diagnósticos, el GRD más frecuente es de patología respiratoria, por lo que se ha de hacer codificación exhaustiva y de calidad para ajustar el peso relativo de los mismos a la realidad. Es fundamental especificar en la fuente de información clínica utilizada para la codificación, el grado de desnutrición, para obtener mayor especificidad en los datos.


Assuntos
Desnutrição/mortalidade , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Desnutrição/diagnóstico , Pessoa de Meia-Idade , Alta do Paciente , Sepse/complicações , Sepse/mortalidade , Espanha
9.
Med Clin (Barc) ; 132(10): 377-84, 2009 Mar 21.
Artigo em Espanhol | MEDLINE | ID: mdl-19268323

RESUMO

BACKGROUND AND OBJECTIVE: In hospitalized patients, malnutrition ranges between 30% and 55% and is associated with a higher rate of complications, prolonged hospitalization and increased cost of health services. Despite this, there is no awareness of the clinical and economic implications involving hospital malnutrition and its treatment. We analyzed the relationship between hospital malnutrition, average length of stay and early readmissions. MATERIAL AND METHODS: It is a prospective and dynamic cohort study, in which patients were observed from the time of their admission and throughout their hospitalization on a weekly basis. The selection was carried out using a systematic random method. Patients were all older than 18 and admitted to the services with an average stay 5 days. It was decided that a patient had malnutrition when some anthropometric (biceps circumference, tricipital, abdominal and subscapular skinfold thickness) or biochemical (albumin, prealbumin, and transferrin) parameter was below normal values. Early readmission was defined as a patient's return to hospital in a period < 31 days from the last date of discharge. Hospital entries were classified in relation to the average stay (hospital and services) and we analyzed the stays below and the stays above the average expected. Results have been expressed in average and standard deviation (X +/- SD) and frequency (%). Intergroup comparisons by Student's t test and chi(2), remain significant to P < .05. The risk and confidence intervals (CI) were applied to malnourished cohorts, with a significance level of 95%. RESULTS: The study included 817 patients (50.9 +/- 18.5 years), 62.9% men and 37.1% women. 45.9% (n = 375) of patients were malnourished, and malnutrition was most common in those with digestive diseases (22.5%), neoplasm (20.8%), circulatory (16.5%) and respiratory pathologies (11.6%). The average stay (hospital and services) and the premature readmission rate were higher in patients admitted to hospital with malnutrition. CONCLUSIONS: Nearly half of the patients presented some degree of malnutrition when they were admitted, increasing hospital stay and premature readmission rate. The high prevalence and incidence of malnutrition requires suggestions to develop mechanisms to determine its real scope and programs to solve it.


Assuntos
Tempo de Internação/estatística & dados numéricos , Desnutrição/epidemiologia , Readmissão do Paciente/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos
10.
Med. clín (Ed. impr.) ; 132(10): 377-384, mar. 2009. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-60604

RESUMO

Fundamento y objetivo: en los sujetos hospitalizados, la desnutrición oscila entre el 30 y el 55%, y se asocia a una mayor tasa de complicaciones, prolongación de la hospitalización e incremento del coste de los servicios sanitarios. A pesar de esto, no se tiene consciencia clara de las implicaciones clínicas y económicas que comportan la desnutrición hospitalaria y su tratamiento. El objetivo de este trabajo fue analizar la relación entre desnutrición hospitalaria, estancia media (EM) y reingresos prematuros. Material y métodos: se trata de un estudio de cohortes, prospectivo y dinámico, en el que se realizó un seguimiento semanal de los sujetos desde su ingreso y durante la hospitalización. La selección se realizó mediante un método sistemático y aleatorizado. Se incluyó a personas mayores de 18 años que ingresaron en los servicios, con EM de 5 o más días. Se ha considerado que un sujeto presentaba desnutrición cuando algún parámetro antropométrico (perímetro braquial y pliegues cutáneos tricipital, abdominal y subescapular) o bioquímico (albúmina, prealbúmina y transferrina) estaba por debajo de los valores considerados normales. Se definió como reingreso prematuro al hecho de que un sujeto volviera a ingresar en un período igual o menor de 31 días desde la última fecha de alta. Las altas hospitalarias se clasificaron en relación con la EM (hospitalaria y por servicios) en estancia inferior y estancia superior a la media esperada. Los resultados se han expresado en media y desviación estándar y en frecuencias (%). Se realizaron comparaciones intergrupales mediante el test de la t de Student y la prueba de χ2, y los resultados fueron significativos para p<0,05. El riesgo relativo y los intervalos de confianza se aplicaron para la cohorte ®desnutrido», con nivel de significación del 95%.Resultadosse incluyó a 817 sujetos (edad media de 50,9±18,5 años); los varones representaron el 62,9%, y las mujeres el 37,1% (...) (AU)


Background and objective: In hospitalized patients, malnutrition ranges between 30% and 55% and is associated with a higher rate of complications, prolonged hospitalization and increased cost of health services. Despite this, there is no awareness of the clinical and economic implications involving hospital malnutrition and its treatment. We analyzed the relationship between hospital malnutrition, average length of stay and early readmissions. Material and methods: It is a prospective and dynamic cohort study, in which patients were observed from the time of their admission and throughout their hospitalization on a weekly basis. The selection was carried out using a systematic random method. Patients were all older than 18 and admitted to the services with an average stay ≥5 days. It was decided that a patient had malnutrition when some anthropometric (biceps circumference, tricipital, abdominal and subscapular skinfold thickness) or biochemical (albumin, prealbumin, and transferrin) parameter was below normal values. Early readmission was defined as a patient's return to hospital in a period<31 days from the last date of discharge. Hospital entries were classified in relation to the average stay (hospital and services) and we analyzed the stays below and the stays above the average expected. Results: have been expressed in average and standard deviation (X±SD) and frequency (%). Intergroup comparisons by Student's t test and χ2, remain significant to P<.05. The risk and confidence intervals (CI) were applied to malnourished cohorts, with a significance level of 95%.ResultsThe study included 817 patients (50.9±18.5 years), 62.9% men and 37.1% women. 45.9% (n=375) of patients were malnourished, and malnutrition was most common in those with digestive diseases (22.5%), neoplasm (20.8%), circulatory (16.5%) and respiratory pathologies (11.6%) (...)(AU)


Assuntos
Humanos , Desnutrição/epidemiologia , /estatística & dados numéricos , Estudos Prospectivos , Readmissão do Paciente/estatística & dados numéricos , Distribuição por Idade e Sexo , Pacientes Internados/estatística & dados numéricos
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