Nutrition impact symptoms, sarcopenia, and malnutrition in hospitalized patients / Sintomas de impacto nutricional, sarcopenia e desnutrição em pacientes hospitalizados

INTRODUCTION: Nutrition Impact Symptoms (NIS) are common in hospitalized patients and can be aggravated in the presence of malnutrition. OBJECTIVE: To verify the presence of NIS and its association with sociodemographic and clinical variables, sarcopenia phenotype, and nutritional status of individuals hospitalized. METHODS: This is a cross-sectional study with hospitalized patients, of both sexes and ≥50 years old. Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength (HGS), gait speed GS), and anthropometric measurements were performed up to 48 hours after admission. NIS was obtained through PG-SGA and stratified into two groups: <3 and ≥3 symptoms. The chi-square test (χ2) was performed, and a 5% significance level was adopted. RESULTS: A total of 90 patients (65.4±9.67 years) were studied, with the majority of men (56.7%), older people (70.0%), married (68.9%), low economic class (72.2%), without work activity (70.5%), with two previous diseases (60.0%), overweight by body mass index (46.7%) and adequate adductor pollicis muscle thickness (83.3%). The most prevalent NIS were "dry mouth", "anorexia", and "smells sick" respectively 31.1%, 30.0%, and 16.7%. There was an association between NIS and SARC-F score (p=0.002), handgrip strength (p=0.016), the status of sarcopenia (p=0.020), PG-SGA (p<0.001), and economic status (p=0.020). CONCLUSION: The identification of NIS is common, and may infer negative nutritional status and functional performance of patients. The use of protocols to identify NIS during hospitalization should be considered to minimize the negative impact on nutritional status.

INTRODUÇÃO: Sintomas de impacto nutricional (SIN) são comuns em pacientes hospitalizados e estes podem ser agravados na presença da desnutrição. OBJETIVO: Verificar a presença de SIN e sua associação com as variáveis sociodemográficas, clínicas, fenótipo de sarcopenia e estado nutricional de indivíduos hospitalizados. MÉTODOS: Trata-se de estudo transversal com pacientes internados, de ambos os sexos e idade ≥ 50 anos. Realizou-se Avaliação Subjetiva Global produzida pelo Paciente (ASG-PPP), força de preensão palmar (FPP), velocidade de caminhada (VC) e medidas antropométricas até 48 horas da admissão. Os SIN foram obtidos por meio da ASG-PPP e compilados em <3 ou ≥3 sintomas. Realizou-se o teste de qui-quadrado (χ2). Adotou-se nível de significância de 5%. RESULTADOS: Um total de 90 pacientes (65,4±9,67 anos), sendo a maioria homem (56,7%), idoso (70,0%), casado (68,9%), classe econômica baixa (72,2%), sem atividade de trabalho (70,5%), com uma a duas doenças pregressas (60,0%), excesso de peso ao índice de massa corporal (46,7%) e adequada espessura do músculo adutor do polegar (83,3%). Os SIN "boca seca", "anorexia" e "cheiros enjoam" foram os mais prevalentes, respectivamente 31,1%, 30,0% e 16,7%. Houve associação dos SIN com as variáveis que compõem o fenótipo de sarcopenia: o escore SARC-F (p=0,002) e FPP (p=0,016), status de sarcopenia (p=0,020), ASG-PPP (p<0,001) e classe econômica (p=0,020). CONCLUSÃO: A identificação de SIN é comum, podendo inferir negativamente no estado nutricional e desempenho funcional dos pacientes. Considerar o uso de protocolos para identificação dos SIN durante a hospitalização a fim de minimizar a repercussão negativa no estado nutricional.

Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in hospitalized individuals / Asociación del espesor del músculo aductor del pulgar y la fuerza de prensión manual con el estado nutricional en individuos hospitalizados

Background: malnutrition is common in hospitalized patients and early diagnosis can contribute to better clinical and nutritional outcomes. Adductor pollicis muscle thickness (APMT) and handgrip strength (HGS) have been used to identify reductions in strength and muscle mass, associated or not with conventional methods. Objective: we aimed to correlate APMT and HGS with conventional anthropometric variables in hospitalized patients, and assess their relationship with nutritional status as evaluated by the Patient-Generated Subjective Global Assessment (PG-SGA) method. Methods: a cross-sectional study was conducted in patients of both sexes admitted to a University Hospital in Brazil. APMT, HGS, and conventional measures were used for anthropometric assessment. PG-SGA was used for the assessment of nutritional status. Results: the sample included 73 patients (66.9 ± 9.6 years). Most patients were admitted for surgery procedures (53.4 %) and had an adequate body mass index (BMI) (47.9 %), while according to PG-SGA most patients (67.1 %) had some degree of malnutrition (B and C). Right-hand (R) APMT was significantly correlated with corrected arm muscle area (cAMA), calf circumference (CC), and HGS. Left-hand (L) APMT was significantly correlated with cAMA, arm circumference (AC), CC, PG-SGA score, and HGS. Both HGS values (R/L) were significantly correlated with CC, PG-SGA score, and APMT. (AU)

Introducción: la desnutrición es común en los pacientes hospitalizados y el diagnóstico temprano puede contribuir a obtener mejores resultados clínicos y nutricionales. El espesor del músculo aductor del pulgar (EMAP) y la fuerza de prensión manual (FPM) se han utilizado para identificar la reducción de la fuerza y la masa muscular, asociados o no a métodos convencionales. Objetivo: nuestro objetivo fue correlacionar el EMAP y la FPM con las variables antropométricas convencionales en pacientes hospitalizados, y evaluar su relación con el estado nutricional evaluado por la valoración global subjetiva generada por el paciente (PG-SGA). Métodos: se realizó un estudio transversal con pacientes de ambos sexos, ingresados en un hospital universitario de Brasil. Se utilizaron el EMAP, la FPM y medidas convencionales para la valoración antropométrica. Se utilizó el método PG-SGA para la valoración del estado nutricional. Resultados: la muestra incluyó a 73 pacientes (66,9 ± 9,6 años). La mayoría de los pacientes ingresaron para someterse a procedimientos quirúrgicos (53,4 %) y tenían un índice de masa corporal (IMC) adecuado (47,9 %), mientras que según la PG-SGA, la mayoría de los pacientes (67,1 %) presentaban algún grado de desnutrición (B y C). El EMAP de la mano derecha se correlacionó significativamente con el área corregida del músculo del brazo (AMBc), la circunferencia de la pantorrilla (CP) y la FPM. El EMAP de la mano izquierda se correlacionó significativamente con las medidas AMBc, circunferencia del brazo, CP, puntuación PG-SGA y FPM. Ambas FPM, derecha e izquierda, se correlacionaron significativamente con las medidas CP, puntuación PG-SGA y EMAP. (AU)

Gait speed and malnutrition in hospitalized patients and the quality of life of their caregivers.

OBJECTIVE: To verify the age, nutritional status, and gait speed in hospitalized individuals, and their association with the quality of life of their caregivers. METHODS: Observational cross-sectional study with 54 patients and their respective caretakers in a university hospital in the Brazilian Midwest. The analyses were carried out using the SPSS software, with p < 0.05. RESULTS: The Social Relations domain had the highest mean score (71.45±18.64). The lowest score was in the Physical domain (57.80±12.01). According to a subjective nutritional evaluation, 72.2% presented some degree of malnutrition. Most were classified with low gait speeds (82%). There was a significant correlation between age and the Physical and General Quality of Life domains. The Environment domain was significantly correlated to the gait speed. CONCLUSION: The age and the gait speed of the patient were related to the quality of life of the caregiver, but the nutritional state was not affected.

Gait speed and malnutrition in hospitalized patients and the quality of life of their caregivers / Velocidad de la marcha y desnutrición en pacientes hospitalizados y calidad de vida de sus cuidadores / Velocidade de marcha e desnutrição em paciente hospitalizados e qualidade de vida de seus cuidadores

ABSTRACT Objective: To verify the age, nutritional status, and gait speed in hospitalized individuals, and their association with the quality of life of their caregivers. Methods: Observational cross-sectional study with 54 patients and their respective caretakers in a university hospital in the Brazilian Midwest. The analyses were carried out using the SPSS software, with p < 0.05. Results: The Social Relations domain had the highest mean score (71.45±18.64). The lowest score was in the Physical domain (57.80±12.01). According to a subjective nutritional evaluation, 72.2% presented some degree of malnutrition. Most were classified with low gait speeds (82%). There was a significant correlation between age and the Physical and General Quality of Life domains. The Environment domain was significantly correlated to the gait speed. Conclusion: The age and the gait speed of the patient were related to the quality of life of the caregiver, but the nutritional state was not affected.

RESUMEN Objetivo: Verificar la relación de la edad, estado nutricional y velocidad de la marcha de indivíduos hospitalizados con la calidad de vida de sus cuidadores. Métodos: Estudio observacional del tipo transversal con 54 pacientes y sus respectivos cuidadores en un hospital universitario del Medio oeste de Brasil. Análisis han sido realizadas en el programa SPSS considerando p < 0,05. Resultados: El dominio Relaciones sociales obtuvo la calificación media más elevada (71,45±18,64) y la más baja ha sido del dominio Físico (57,80±12,01). Segundo evaluación nutricional subjetiva, 72,2% presentaban alguno grado de desnutrición. La mayoría ha sido clasificada con baja velocidad de la marcha (82%). Se encontró correlación significativa entre la edad y los dominios Físico y Calidad de vida general. El dominio Ambiente se ha correlacionado significativamente con la velocidad de marcha. Conclusión: La edad y la velocidad de la marcha del paciente han estado relacionadas con la calidad de vida del cuidador, pero no encontramos impacto en el estado nutricional.

RESUMO Objetivo: Verificar a relação da idade, estado nutricional e velocidade de marcha de indivíduos hospitalizados com a qualidade de vida de seus cuidadores. Métodos: Estudo observacional do tipo transversal com 54 pacientes e seus respectivos cuidadores em um hospital universitário da região Centro-Oeste do Brasil. Análises foram realizadas no programa SPSS considerando p < 0,05. Resultados: O domínio Relações sociais obteve o escore médio mais elevado (71,45±18,64) e o mais baixo foi do domínio Físico (57,80±12,01). Segundo avaliação nutricional subjetiva, 72,2% apresentavam algum grau de desnutrição. A maioria foi classificada com baixa velocidade de marcha (82%). Encontrou-se correlação significativa entre a idade e os domínios Físico e Qualidade de vida geral. O domínio Ambiente correlacionou-se significativamente com a velocidade de marcha. Conclusão: A idade e a velocidade de marcha do paciente estiveram relacionadas com a qualidade de vida do cuidador, porém não encontramos impacto no estado nutricional.