Acceptance of Low-Sodium Hospital Diet by Cardiac Patients: A Randomized Controlled Crossover Trial

Abstract Background Cardiovascular diseases are the major cause of hospitalization. Dietary salt restriction is indicated as part of clinical treatment, however, it is not always well accepted by the patients, resulting in low food intake and malnutrition. Objective To compare acceptance of a low-sodium diet cooked with salt with a standard low-sodium diet in cardiac inpatients. Methods A randomized controlled crossover trial in patients with low-sodium diet prescriptions (Clinical Trials NCT03481322). Patients were given a control standard low sodium diet (cooked without salt; salt [2g per meal] added by the patient at the time of consumption) on one day and on the next day patients were given the intervention diet - a low sodium diet cooked with salt (2 grams of salt, divided between preparations). Dietary acceptance was evaluated by weighing leftover food and calculating intake. A questionnaire was used to verify reasons that influenced acceptance. For data analysis, parametric data are presented as mean and standard deviation, Student's t test was used to compare means, with significance defined as p<0.05. Results Sixty-four patients were evaluated, with a mean age of 66 ± 11.3 years; 64% were male. There were no differences in percentage acceptance between the standard low-sodium diet and the low-sodium diet cooked with salt at lunch (p= 0.876) or at dinner (p= 0.255). Around 80% of what was offered at each meal was consumed by the patients, with no significant difference between groups. Conclusions The low-sodium diet cooked with salt was well accepted, but there was no difference when compared with the standard low-sodium diet, which also had adequate acceptance.

Prognostic factors in patients with pressure sores in a university hospital in southern brazil / Fatores prognósticos em pacientes com úlceras de pressão em hospital universitário no sul do brasil

ABSTRACT Objective: Despite advances in medical care, patients who are hospitalized or have spinal cord injuries often develop pressure sores. The objective of this study was to describe the epidemiological characteristics of pressure sores and evaluate factors associated with recurrence and cure. Methods: In this historical cohort study, clinical and laboratory data were collected from medical records between 1997 and 2016. Results: Sixty individuals with pressure ulcers were included; mean patient age was 38.1±16.5 (37.0) years, 83.3% were men, and 86.8% identified as white. Most patients (85.1%) had paraplegia, amputation, or trauma of the lower limbs with motor sequelae; the remainder (14.9%) were quadriplegic. Most (78.3%) underwent surgery, and the mean follow-up time was 1.8±2.5 years. The lesions were cured in 25 patients; they recurred in 25% of the patients, and recurrence was seen to be associated with the location of the lesions. Patients with recurrent lesions had more medical consultations and a longer treatment time. Individuals whose ulcers had healed had fewer lesions, higher body mass index (BMI), and a higher proportion of these patients underwent surgery. Conclusions: BMI and location and number of lesions are prognostic factors. Level of Evidence IV, Case Series.

RESUMO Objetivo: Apesar do progresso dos cuidados médicos, os pacientes hospitalizados ou com lesões medulares frequentemente desenvolvem úlceras de pressão. O objetivo deste estudo foi descrever as características epidemiológicas das úlceras de pressão e avaliar os fatores associados à recorrência e à cura. Métodos: Neste estudo de coorte histórico, foram coletados dados clínicos e laboratoriais de prontuários médicos de 1997 a 2016. Resultados: Sessenta indivíduos com úlceras de pressão foram incluídos. A média de idade dos pacientes foi 38,1 ± 16,5 (37,0) anos, 83,3% eram homens e 86,8% foram identificados como brancos. A maioria dos pacientes (85,1%) tinha paraplegia, amputação ou trauma nos membros inferiores com sequelas motoras; os restantes (14,9%) eram tetraplégicos. A maioria dos pacientes (78,3%) foi submetida à cirurgia e o tempo médio de acompanhamento foi 1,8±2,5 anos. A cicatrização das lesões foi observada em 25 pacientes; houve recorrência em 25% dos pacientes e verificou-se que estavam associadas à localização das lesões. Os pacientes com lesões recorrentes tinham maior número de consultas médicas e maior tempo de tratamento. Os indivíduos cujas úlceras cicatrizaram tinham menos lesões, maior índice de massa corporal (IMC) e maior proporção deles foi submetida à cirurgia. Conclusões: O IMC, a localização e o número de lesões são fatores prognósticos. Nível de Evidência IV, Série de Casos.

PROGNOSTIC FACTORS IN PATIENTS WITH PRESSURE SORES IN A UNIVERSITY HOSPITAL IN SOUTHERN BRAZIL.

OBJECTIVE: Despite advances in medical care, patients who are hospitalized or have spinal cord injuries often develop pressure sores. The objective of this study was to describe the epidemiological characteristics of pressure sores and evaluate factors associated with recurrence and cure. METHODS: In this historical cohort study, clinical and laboratory data were collected from medical records between 1997 and 2016. RESULTS: Sixty individuals with pressure ulcers were included; mean patient age was 38.1±16.5 (37.0) years, 83.3% were men, and 86.8% identified as white. Most patients (85.1%) had paraplegia, amputation, or trauma of the lower limbs with motor sequelae; the remainder (14.9%) were quadriplegic. Most (78.3%) underwent surgery, and the mean follow-up time was 1.8±2.5 years. The lesions were cured in 25 patients; they recurred in 25% of the patients, and recurrence was seen to be associated with the location of the lesions. Patients with recurrent lesions had more medical consultations and a longer treatment time. Individuals whose ulcers had healed had fewer lesions, higher body mass index (BMI), and a higher proportion of these patients underwent surgery. CONCLUSIONS: BMI and location and number of lesions are prognostic factors. Level of Evidence IV, Case Series.

OBJETIVO: Apesar do progresso dos cuidados médicos, os pacientes hospitalizados ou com lesões medulares frequentemente desenvolvem úlceras de pressão. O objetivo deste estudo foi descrever as características epidemiológicas das úlceras de pressão e avaliar os fatores associados à recorrência e à cura. MÉTODOS: Neste estudo de coorte histórico, foram coletados dados clínicos e laboratoriais de prontuários médicos de 1997 a 2016. RESULTADOS: Sessenta indivíduos com úlceras de pressão foram incluídos. A média de idade dos pacientes foi 38,1 ± 16,5 (37,0) anos, 83,3% eram homens e 86,8% foram identificados como brancos. A maioria dos pacientes (85,1%) tinha paraplegia, amputação ou trauma nos membros inferiores com sequelas motoras; os restantes (14,9%) eram tetraplégicos. A maioria dos pacientes (78,3%) foi submetida à cirurgia e o tempo médio de acompanhamento foi 1,8±2,5 anos. A cicatrização das lesões foi observada em 25 pacientes; houve recorrência em 25% dos pacientes e verificou-se que estavam associadas à localização das lesões. Os pacientes com lesões recorrentes tinham maior número de consultas médicas e maior tempo de tratamento. Os indivíduos cujas úlceras cicatrizaram tinham menos lesões, maior índice de massa corporal (IMC) e maior proporção deles foi submetida à cirurgia. CONCLUSÕES: O IMC, a localização e o número de lesões são fatores prognósticos. Nível de Evidência IV, Série de Casos.