Postoperative complication rate and survival of patients with gastric cancer undergoing immunonutrition: A retrospective study.

OBJECTIVES: This study aimed to evaluate the effect of preoperative immunonutrition on the rate of postoperative complication and survival of patients with gastric cancer. METHODS: A retrospective cohort was formed after data collection of patients hospitalized with gastric cancer. Postoperative complications classified according to the Clavien-Dindo classification system, length of hospital stay, readmissions, and rates of survival at 6 mo, 1 y, and 5 y were analyzed. A χ2 or Fisher's exact test, Student or Mann-Whitney t test, and Kaplan-Meier and Cox regressions were used in the statistical analysis. RESULTS: A total of 164 patients were included in the study, with 56 patients assigned to the immunonutrition group and 108 to the conventional group. There were no significant differences in postoperative complications between the immunonutrition and conventional groups (51.8% versus 58.3%; P = 0.423). The most frequent complications were fistula and surgical wound infection. Length of hospital stay did not differ between the groups (median of 7.0 d: P = 0.615) and the presence of readmissions did not differ either (12.5% versus 15.7%; P = 0.648). In the multivariate Cox regression, in a pooled model for group, age, sex, body mass index, Charlson comorbidity index, staging, neoadjuvant chemotherapy, and type of surgery, there was a significant difference in survival rates at 6 mo (P = 0.011), 1 y (P = 0.006), and 5 y (P < 0.001). CONCLUSIONS: Preoperative immunonutrition in patients with gastric cancer did not reduce postoperative complications or length of hospital stay. More studies are needed to confirm the benefit of immunonutriton supplementation for overall survival when associated with other protective factors.

Perfil epidemiológico de usuários atendidos em ação de saúde na Baixada Litorânea do Rio de Janeiro / Epidemiological profile of users served on health action in the Coastal Lowlands of Rio de Janeiro / Perfil epidemiológico de los usuarios sobre la acción sanitaria en las tierras bajas costeras de Río de Janeiro

Objetivo: identificar o perfil epidemiológico dos usuários atendidos em ação de saúde na Baixada Litorânea do Rio de Janeiro. Método: trata-se de um estudo descritivo, retrospectivo, exploratório de natureza quantitativa que utilizou como delineamento a pesquisa documental por meio da análise de dados secundários. Resultados: foram avaliados 746 registros, com prevalência do sexo feminino (69,7%), idade entre 20 e 29 anos (41,6%), ensino superior incompleto (63,9%) e estado civil solteiro (69,4%). O sexo masculino apresentou uma média mais elevada de níveis pressóricos quando comparado com as mulheres. Evidenciou-se que com o avançar da idade e baixa escolaridade, maiores são os níveis de pressão arterial e glicêmicos. Conclusão: estudos que ampliam o conhecimento sobre o perfil epidemiológico de uma população representam uma ferramenta importante para subsidiar o cuidado em saúde

Objective: to reveal the epidemiological profile of the users met in health action in the Coastal Lowlands of Rio de Janeiro. Method: this is a descriptive study, retrospective, exploratory quantitative in nature used as documentary research design through the analysis of secondary data. Results: 746 records were evaluated, with female prevalence (69.7%), age between 20 and 29 years (41.6%), incomplete higher education (63.9%) and marital status single (69.4%). Males showed an average blood pressure higher when compared with the female. It was evidenced that with advancing age and lower educational level, the greater the blood pressure and blood glucose levels. Conclusion: it is considered that studies about the knowledge of the epidemiological profile of a population becomes an important tool to support health actions

Objetivo: identificar el perfil epidemiológico de los usuarios se reunieron en la acción sanitaria en las tierras bajas costeras de Río de Janeiro. Método: se trata de un estudio descriptivo, retrospectivo, utilizado cuantitativo en naturaleza exploratoria como diseño de investigación documental a través del análisis de datos secundarios. Resultados: se evaluaron registros de 746, con predominio femenino (69.7%), edad entre 20 y 29 años (41.6%), educación superior incompleta (63.9%) y el estado civil solo (69,4%). Los varones mostraron mayor los niveles de presión arterial media en comparación con las mujeres. Se evidenció que con el avance de edad y menor nivel educativo, mayor será los niveles de glucosa en sangre y presión arterial. Conclusión: estudios que amplían el conocimiento sobre el perfil epidemiológico de una población representan una herramienta importante para apoyar la atención de la salud

Relationship between patient-generated subjective global assessment and survival in patients in palliative care.

BACKGROUND: A significant number of cancer deaths is partly due to late diagnosis of the disease at an advanced stage beyond cure. In this context, by applying the adequate tools, palliative care provides terminal cancer patients with the proper support for survival with a higher quality of life. The objective of this study was to describe the nutritional profile of terminal cancer patients and to evaluate the relationship among Patient-Generated Subjective Global Assessment (PG-SGA) score, clinical-functional characteristics and survival. METHODS: The present work is a retrospective cohort study with 104 terminal cancer patients. The Karnofsky Performance Status (KPS) was used to obtain socio-demographic data and clinical history and assess functional capacity. Furthermore, patients were classified by groups and PG-SGA score ranges. RESULTS: In the first medical consultation, the PG-SGA revealed that most patients were moderately or severely malnourished and in critical need of immediate symptom management. Functional capacity of almost half of all patients lay within a KPS score of 40 to 70. Survival analysis revealed that the median time of mortality by cancer was 5 (3.3-6.7) months. Furthermore, patients with an SGA-C, i.e., severely malnourished (P<0.001), a PG-SGA score ≥9 (P=0.036) and a KPS score ≤40 (P<0.001) had a lower median time of survival. CONCLUSIONS: In addition to evaluating nutritional status, the PG-SGA is directly related with survival in terminal cancer patients. The use of this tool in the studied population is of paramount importance to provide individualised and adequate support for these patients.