Perfil alimentar de transplantados cardíacos de um centro transplantador brasileiro - Atuação da enfermagem neste cenário / Perfil alimentario de los trasplantes de corazón en un centro de trasplante brasileño - Desempeño de la enfermería en este escenario / Food profile of heart transplants in a brazilian transplantation center - Nursing performance in this scenario

Objetivo- Descrever o perfil alimentar de pacientes pós transplante cardíaco (TC) tardio de um centro transplantador brasileiro. Método- Estudo observacional transversal com delineamento descritivo. O estudo ocorreu em uma instituição de ensino público de Minas Gerais. A coleta de dados ocorreu no período de 2017 a 2019. Resultados-. A amostra do estudo foi composta por 62 indivíduos transplantados entre os anos de 2006 a 2016. Aproximadamente 63% era do sexo masculino. A média de idade foi de 46,53 anos. O consumo de carboidratos e gorduras foi adequado em 46,77% e 59,68% da amostra, respectivamente. Já o consumo de proteínas foi acima do recomendado em 77,42% e o consumo de fibras abaixo do recomendado em 79,03%. Conclusão- Houve a predominância do sexo masculino. Os indivíduos apresentaram um consumo adequado somente de carboidratos e gorduras. Não houve na literatura estudos descrevendo a atuação do enfermeiro no processo de nutrição neste cenário(AU)

Objective- To describe the dietary profile of patients after late heart transplantation (HT) from a Brazilian transplant center. Method- Cross-sectional observational study with descriptive design. The study took place in a public education institution in Minas Gerais. Data collection took place from 2017 to 2019. Results-. The study sample consisted of 62 individuals transplanted between 2006 and 2016. Approximately 63% were male. The mean age was 46.53 years. The consumption of carbohydrates and fats was adequate in 46.77% and 59.68% of the sample, respectively. The consumption of proteins was above the recommended in 77.42% and the consumption of fibers below the recommended in 79.03%. Conclusion- There was a predominance of males. The individuals presented an adequate consumption of only carbohydrates and fats. There were no studies in the literature describing the role of nurses in the nutrition process in this scenario(AU)

Objetivo- Describir el perfil dietético de pacientes después de un trasplante cardíaco (TC) tardío de un centro de trasplante brasileño. Método- Estudio observacional transversal con diseño descriptivo. El estudio se llevó a cabo en una institución de educación pública en Minas Gerais. La recolección de datos se llevó a cabo de 2017 a 2019. Resultados-. La muestra del estudio estuvo compuesta por 62 individuos trasplantados entre 2006 y 2016. Aproximadamente el 63% eran hombres. La edad media fue de 46,53 años. El consumo de carbohidratos y grasas fue adecuado en el 46,77% y 59,68% de la muestra, respectivamente. El consumo de proteína estuvo por encima del nivel recomendado en un 77,42% y el consumo de fibra por debajo del nivel recomendado en un 79,03%. Conclusión- Hubo predominio del sexo masculino. Los individuos presentaron un consumo adecuado de solo carbohidratos y grasas. No hubo estudios en la literatura que describieran el papel del enfermero en el proceso de nutrición en este escenario.(AU)

Comparison of Quality of Life Between Patients with Advanced Heart Failure and Heart Transplant Recipients

Abstract Introduction: Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). The transplant is expected to increase survival and improve the level of health-related quality of life (HRQoL). The aim of this study was to compare the level of HRQoL, as well as social and clinical variables, between patients with advanced HF and heart transplant (HT) recipients. Methods: This is a cross-sectional study, conducted at a Brazilian university hospital, during outpatient consultations. The level of HRQoL was assessed using the World Health Organization Quality of Life-Bref questionnaire. Descriptive statistics were used to analyze the data, and the comparison of the level of HRQoL was performed using the Mann-Whitney U test. Results: Two hundred sixty-two patients participated in the study. Seventy-nine of them had advanced-stage HF and 183 were HT recipients. Compared to patients with advanced HF, HT recipients had a better level of HRQoL, were less frequently absent from work due to health problems, had higher income, used a higher number of medications, and there was a higher percentage of retirees among them (P-value < 0.001). Conclusion: In every comparison, HT recipients showed a better level of HRQoL than patients with advanced HF, along with less absence from work and higher income. These results suggest that heart transplantation can improve HRQoL and survival of patients with advanced HF.

Comparison of Quality of Life Between Patients with Advanced Heart Failure and Heart Transplant Recipients.

INTRODUCTION: Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). The transplant is expected to increase survival and improve the level of health-related quality of life (HRQoL). The aim of this study was to compare the level of HRQoL, as well as social and clinical variables, between patients with advanced HF and heart transplant (HT) recipients. METHODS: This is a cross-sectional study, conducted at a Brazilian university hospital, during outpatient consultations. The level of HRQoL was assessed using the World Health Organization Quality of Life-Bref questionnaire. Descriptive statistics were used to analyze the data, and the comparison of the level of HRQoL was performed using the Mann-Whitney U test. RESULTS: Two hundred sixty-two patients participated in the study. Seventy-nine of them had advanced-stage HF and 183 were HT recipients. Compared to patients with advanced HF, HT recipients had a better level of HRQoL, were less frequently absent from work due to health problems, had higher income, used a higher number of medications, and there was a higher percentage of retirees among them (P-value < 0.001). CONCLUSION: In every comparison, HT recipients showed a better level of HRQoL than patients with advanced HF, along with less absence from work and higher income. These results suggest that heart transplantation can improve HRQoL and survival of patients with advanced HF.

Health-Related Quality of Life of Heart Transplant Recipients Living in a Developing Country.

BACKGROUND: Heart transplantation (HT) is the treatment for patients with end-stage heart failure (HF). It is hoped that the procedure increases both survival rates and the level of health-related quality of life (HRQoL), which may, however, be compromised by post-transplant complications. The objective of this study was to analyze the level of HRQoL in HT recipients and considered the influence of variables from social and clinical contexts. MATERIALS AND METHODS: This is a cross-sectional study of HT recipients. The level of HRQoL was assessed by the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire during outpatient consultation. RESULTS: This study analyzed 186 HT recipients from a total of 192 eligible patients. The median level of HRQoL was ≥67.8 points in all domains of the WHOQOL-BREF questionnaire (physical, psychological, social relationships, and environment) and general score of perception of the level of quality of life (QoL) and health. Variables such as age, ethnicity, per capita income, time from last hospitalization, number of current medications, and number of hospitalizations after HT were significantly related to at least 1 domain of the WHOQOL-BREF. CONCLUSION: In this study, HRQoL of HT recipients living in a developing country can be considered satisfactory given the high score obtained in all domains of WHOQOL-BREF and in the perception of the level of QoL and health.

Análise da qualidade de vida de pacientes com insuficiência cardíaca avançada candidatos ou não ao transplante cardíaco / Analysis of the quality of life of patients with advanced heart failure candidates or not for heart transplantation / Análisis de la calidad de vida de los pacientes con insuficiencia cardíaca avanzada, candidatos o no a trasplante de corazón

Introdução: a insuficiência cardíaca (IC) é um grave problema de saúde. Pacientes com IC em estágio avançado apresentam, além de baixa expectativa de vida, alteração no nível de qualidade de vida (QV). Objetivo: analisar o nível de QV de pacientes com IC avançada, candidatos ou não ao transplante cardíaco (TC). Método: estudo transversal realizado em um hospital universitário brasileiro, em que os pacientes foram submetidos à avaliação da QV pelo Minnesota Living With Heart Failure Questionnaire (MLHFQ). Resultados: participaram do estudo 76 pacientes. A principal etiologia da IC foi a chagásica (25 pacientes). As classes funcionais mais frequentes foram NYHA II (26 pacientes) e III (33 pacientes). Pacientes em avaliação para TC e aqueles em fila para TC não apresentaram diferença estatisticamente significativa na avaliação do nível de QV. A pontuação dos pacientes segundo as dimensões avaliadas no MLHFQ foram: dimensão física com mediana 28,5; emocional, 13; outras questões, 21; e, no escore total, 61. O modelo final na análise multivariada demonstrou que a QV está associada a variáveis como classe funcional da IC, número de medicações em uso, número de comorbidades e a ocupação do lar. Discussão e Conclusão: a IC é doença grave, que impacta negativamente na sobrevida e na QV. Neste estudo, o nível de QV dos pacientes esteve associado à classe funcional da IC - NYHA, ao número de medicações em uso e à ocupação do lar. Ações que estimulem e favoreçam a adesão ao tratamento otimizado devem ser incentivadas.(AU)

Introduction: heart Failure (HF) is a serious health problem. Patients with an advanced stage of HF present, besides low life expectancy, a change in the Quality of Life (QoL) level. Objective: to analyze the QoL level of advanced HF patients, candidates or not for Heart Transplantation (HT). Method: a cross-sectional study carried out in a Brazilian university hospital, in which patients were submitted to QoL evaluation by the Minnesota Living With Heart Failure Questionnaire (MLHFQ). Results: 76 patients participated in the study. The main etiology of HF was chagasic (25 patients). The most frequent functional classes were NYHA II (26 patients) and III (33 patients). Patients under evaluation for HT and those in the queue for HT did not show a statistically significant difference in the evaluation of the QoL level. The score of the patients according to the dimensions assessed in the MLHFQ were the following: physical dimension with a median of 28.5; emotional, 13; other questions, 21; and, in the total score, 61. The final model in the multivariate analysis showed that QoL is associated with variables such as HF functional class, number of using medications, number of comorbidities and household occupation. Discussion and Conclusion: HF is a serious disease that ...(AU)

Introducción: la insuficiencia cardíaca (IC) es un problema de salud grave. Los pacientes con IC avanzada tienen, además de baja esperanza de vida, alteraciones en su calidad de vida (CV). Objetivo: analizar la calidad de vida de pacientes con IC avanzada, candidatos o no para trasplante de corazón (TC). Método: estudio transversal realizado en un hospital universitario brasileño, en el que los pacientes se sometieron a una evaluación de calidad de vida mediante el cuestionario Minnesota Living With Heart Failure Questionnaire (MLHFQ). Resultados: 76 pacientes participaron en el estudio. La etiología principal de la insuficiencia cardíaca fue mal de Chagas (25 pacientes). Las clases funcionales más frecuentes fueron NYHA II (26 pacientes) y III (33 pacientes). Los pacientes bajo evaluación para TC y aquellos en fila de espera para TC no mostraron diferencias estadísticamente significativas en la evaluación del nivel de calidad de vida. Las puntuaciones de los pacientes según las dimensiones evaluadas en el MLHFQ fueron: dimensión física con promedio de 28,5; emocional, 13; otros asuntos, 21; y, en el puntaje total, 61. El modelo final en el análisis multivariado demostró que la calidad de vida está asociada con variables como la clase funcional de IC, la cantidad de medicamentos en uso, la cantidad de comorbilidades y la ocupación dueña de casa. Discusión y conclusión: la insuficiencia cardíaca es una enfermedad grave que afecta negativamente la supervivencia y la calidad de vida. En este estudio, el nivel de calidad de vida de los pacientes se asoció con la clase funcional de IC - NYHA, la cantidad de medicamentos en uso y la ocupación dueña de casa. Deben fomentarse acciones que estimulen y favorezcan la adherencia al tratamiento optimizado.(AU)

Profile of Effective Donors for Heart Transplantation: Experience of a Brazilian Center.

BACKGROUND: Brazil's transplant network is a consolidated, worldwide-recognized program, with about 96% of heart transplantations (HTs) financed by its Unified Health System. It is known that the number of HTs has risen in the past few years, but it still does not meet the demand. This study aims to characterize the profile of the heart donors of a Brazilian center and ascertain the factors contributing to the increase in number of HTs. MATERIALS AND METHODS: This is a cross-sectional and analytical study, developed between 2012 and 2018 at a Brazilian transplant center. RESULTS: There were 210 donations for HT in this period. The median age of donors in years (range) was 33 (24-40), and the donors were 15.5 years younger than the recipients (P value < .001). One hundred forty-two donors (67.6%) were male, 98 (46.7%) were mullato, and 115 (54.8%) had cranioencephalic trauma as the cause of brain death. The distance from the transplant center to the organ procurement area was short in 183 (87.1%) cases, enabling a allograft ischemic time with a median of 125 minutes. There was a relevant association between donor age and cause of brain death (P < .001), sex and cause of brain death (P < .001), and organ procurement area and allograft ischemic time (P < .001). Hospitals that provide urgent and emergency care served as sources for a larger number of organ donations. CONCLUSIONS: This study concluded that the profile of most donors for HT include young adult mullato men who were victims of cranioencephalic trauma. In addition, these donors had few comorbidities and a median age of 33 years.