Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/7804 |
Resumo: | Background: Malnutrition prevalence in hospitalized elderly varies between 2 and 80%, depending on a diversity of factors involved in the diagnosis, such as the heterogeneity of the elderly population, place where they live and diagnostic criteria used. Moreover, malnutrition etiology is multifactorial, leading to an increased morbidity and mortality. Researchers have recently proposed the use of the hand grip strength (HGS) for the nutritional state screening, due to its simple, rapid and low-cost application. This proposal was based on previous studies demonstrating that malnutrition leads to atrophy of type II muscle fibers and alterations of the Z band, reducing strength even before changes in anthropometric measurements can be observed. Aim: The aims of the present study were: (1) to determine the validity of HGS isolated and combined with the Mini Nutritional Assessment (MNA®) and Mini Nutritional Assessment-short form (MNA®-SF) in the malnutrition risk identification in hospitalized elderly; (2) to analyze the association of HGS with sociodemographic, anthropometric, medical clinical variables, nutritional status and malnutrition risk; (3) to determine a HGS cutoff value for malnutrition risk identification.Methods: This was a cross-sectional and analytical study that involved the evaluation of 281 hospitalized elderly patients in a university hospital in Porto Alegre/Brazil. The investigated population was composed of clinical and surgical patients that were able to perform the HGS assessment by means of the Jamar® dynamometer. The nutritional status was determined through the Global Subjective Assessment (GSA) and the malnutrition risk was evaluated through the MNA® and MNA®-SF. The HGS association and correlation analysis with the sociodemographic, anthropometric and medical variables, as well as the nutritional status and nutritional risk, were performed through the Mann-Whitney test, Kruskal-Wallis followed by SNK, and Spearman’s correlation. For the ROC curves regarding the HGS associated with the GSA, and determination of the HGS accuracy when isolated or combined with MNA® and MNA®-SF, two categories were considered: eutrophic and at malnutrition risk/malnourished. Results: The majority of the evaluated elderly patients were males (58.0%), with a mean age of 69.1±6.6 years old (60-94 years old). The prevalence of nutritional risk/malnutrition was 44.5% according to GSA, 51.2% by MNA® and 66.2% by MNA®-SF. Median HGS was significantly lower in females [9.17 kg (6.00-21.42) versus 19.67 kg (14.67-24.33); P<0.001], in individuals ≥80 years old [12.67 (7.33-19.33) versus 16.00 kg (10.00-22.08); P<0.001]; and with low-income [13.17 kg (8.00-20.00) versus 19.50 kg (14.42-26.58); P<0.001]. HGS was significantly associated with the nutritional status (P<0.001). Mean HGS was significantly higher in eutrophic individuals when compared to malnourished individuals (evaluated by the three nutritional status instruments). HGS combined with MNA® or MNA®-SF showed a higher sensitivity (93.6 %; IC95%: 0.833-0. 969 and 98.4%; IC95%: 0.943-0.997, respectively) than did HGS isolated (63.2%; IC95%: 0.563-0.698) in malnutrition risk identification. Conclusion: In summary, HGS can be considered a sensitive tool in the malnutrition screening in hospitalized elderly patients when combined with MNA® or MNA®-SF. |
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Rosa, Melissa Côrtes daSchwanke, Carla Helena Augustinhttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4707856Y2http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4165730A02018-01-11T18:00:30Z2016-03-28http://tede2.pucrs.br/tede2/handle/tede/7804Background: Malnutrition prevalence in hospitalized elderly varies between 2 and 80%, depending on a diversity of factors involved in the diagnosis, such as the heterogeneity of the elderly population, place where they live and diagnostic criteria used. Moreover, malnutrition etiology is multifactorial, leading to an increased morbidity and mortality. Researchers have recently proposed the use of the hand grip strength (HGS) for the nutritional state screening, due to its simple, rapid and low-cost application. This proposal was based on previous studies demonstrating that malnutrition leads to atrophy of type II muscle fibers and alterations of the Z band, reducing strength even before changes in anthropometric measurements can be observed. Aim: The aims of the present study were: (1) to determine the validity of HGS isolated and combined with the Mini Nutritional Assessment (MNA®) and Mini Nutritional Assessment-short form (MNA®-SF) in the malnutrition risk identification in hospitalized elderly; (2) to analyze the association of HGS with sociodemographic, anthropometric, medical clinical variables, nutritional status and malnutrition risk; (3) to determine a HGS cutoff value for malnutrition risk identification.Methods: This was a cross-sectional and analytical study that involved the evaluation of 281 hospitalized elderly patients in a university hospital in Porto Alegre/Brazil. The investigated population was composed of clinical and surgical patients that were able to perform the HGS assessment by means of the Jamar® dynamometer. The nutritional status was determined through the Global Subjective Assessment (GSA) and the malnutrition risk was evaluated through the MNA® and MNA®-SF. The HGS association and correlation analysis with the sociodemographic, anthropometric and medical variables, as well as the nutritional status and nutritional risk, were performed through the Mann-Whitney test, Kruskal-Wallis followed by SNK, and Spearman’s correlation. For the ROC curves regarding the HGS associated with the GSA, and determination of the HGS accuracy when isolated or combined with MNA® and MNA®-SF, two categories were considered: eutrophic and at malnutrition risk/malnourished. Results: The majority of the evaluated elderly patients were males (58.0%), with a mean age of 69.1±6.6 years old (60-94 years old). The prevalence of nutritional risk/malnutrition was 44.5% according to GSA, 51.2% by MNA® and 66.2% by MNA®-SF. Median HGS was significantly lower in females [9.17 kg (6.00-21.42) versus 19.67 kg (14.67-24.33); P<0.001], in individuals ≥80 years old [12.67 (7.33-19.33) versus 16.00 kg (10.00-22.08); P<0.001]; and with low-income [13.17 kg (8.00-20.00) versus 19.50 kg (14.42-26.58); P<0.001]. HGS was significantly associated with the nutritional status (P<0.001). Mean HGS was significantly higher in eutrophic individuals when compared to malnourished individuals (evaluated by the three nutritional status instruments). HGS combined with MNA® or MNA®-SF showed a higher sensitivity (93.6 %; IC95%: 0.833-0. 969 and 98.4%; IC95%: 0.943-0.997, respectively) than did HGS isolated (63.2%; IC95%: 0.563-0.698) in malnutrition risk identification. Conclusion: In summary, HGS can be considered a sensitive tool in the malnutrition screening in hospitalized elderly patients when combined with MNA® or MNA®-SF.Introdução: A prevalência de desnutrição em idosos hospitalizados varia entre 2 e 80%, devido a diversidade de fatores envolvidos no diagnóstico, como a heterogeneidade da população idosa, o cenário de atenção à saúde e o critério diagnóstico utilizado. A etiologia da desnutrição é multifatorial. Suas consequências são o aumento da morbidade e mortaliade. No rastreio nutricional, pesquisadores têm proposto a utilização da força de preensão palmar (FPP), por ser de aplicação simples, rápida e de baixo custo. A proposta foi baseada em estudos que revelaram que a desnutrição leva à atrofia das fibras musculares do tipo II e alterações da banda Z, reduzindo a força antes mesmo de mudanças nas medidas antropométricas. Objetivos: (1) determinar a validade da FPP isolada e combinada com a Mini Avaliação Nutricional (MNA®) e MNA versão reduzida (MNA®-SF) na identificação de risco de desnutrição em idosos hospitalizados; (2) analisar a associação da FPP com variáveis sociodemográficas, antropométricas, clínicas, estado nutricional e risco de desnutrição; (3) determinar o ponto de corte da FPP para risco de desnutrição. Métodos: O estudo foi transversal e analítico, envolvendo a avaliação de 281 idosos internados em um hospital universitário do município de Porto Alegre/RS/Brasil. Foram incluídos pacientes clínicos e cirúrgicos aptos a serem submetidos à avaliação da FPP que foi mensurada por meio de dinamômetro Jamar®. O estado nutricional foi determinado pela Avaliação Subjetiva Global (ASG) e o risco de desnutrição foi determinado pela MNA® e pela MNA®-SF. Para as análises de associação e correlação da FPP com variáveis sociodemográficas, antropométricas, clínicas, estado nutricional e risco nutricional foram utilizados os testes Mann-Whitney, Kruskcal Walis seguido do teste SNK e correlação de Spearman. Para a curva ROC da FPP em relação à ASG e a acurácia da FPP isolada e combinada com a MNA® e MNA®-SF, foram consideradas duas categorias: eutrófico e risco de desnutrição/desnutrição. Resultados: Na presente dissertação, os resultados foram apresentados na forma de um artigo original. A maioria dos idosos era do sexo masculino (58,0%). A média da idade foi 69,1±6,6 anos (60- 94 anos). A prevalência de risco de nutrição/desnutrição foi 44,5% pela ASG, 51,2% pela MNA® e 66,2% pela MNA®-SF. A mediana da FPP foi significativamente menor nas mulheres [9,17 kg (6,00-21,42) versus 19,67 kg (14,67-24,33); P<0,001], nos indivíduos com idade≥80 anos [12,67 kg (7,33-19,33) versus 16,00 kg (10,00-22,08); P<0,001] e nos indivíduos com menor renda mensal [13,17 kg (8,00-20,00) versus 19,50 kg (14,42-26,58); P<0,001]. A FPP apresentou associação com o estado nutricional (P<0,001). O valor médio da FPP foi significativamente maior nos indivíduos eutróficos em relação aos desnutridos (identificado pelos três instrumentos nutricionais). A sensibilidade da FPP combinada de forma paralela com a MNA® (Se 93,6 %; IC95%: 0,833-0,969) e com a MNA®-SF (Se 98,4%; IC95%: 0,943-0,997) mostrou-se maior que da FPP isolada (Se 63,2%; IC95%: 0,563-0,698) na identificação de risco de desnutrição/desnutrição. Conclusão: Pode-se concluir, assim, que a FPP é um instrumento mais sensível no rastreio de risco de desnutrição quando combinada com a MNA® e a MNA®-SF.Submitted by PPG Gerontologia Biomédica (geronbio@pucrs.br) on 2018-01-10T18:05:02Z No. of bitstreams: 1 ROSA_MELISSA_CORTES_DISSERTAÇÃO.pdf: 1811235 bytes, checksum: a5445306dcac7e5c2d450aadcdf48c11 (MD5)Approved for entry into archive by Tatiana Lopes (tatiana.lopes@pucrs.br) on 2018-01-11T17:48:11Z (GMT) No. of bitstreams: 1 ROSA_MELISSA_CORTES_DISSERTAÇÃO.pdf: 1811235 bytes, checksum: a5445306dcac7e5c2d450aadcdf48c11 (MD5)Made available in DSpace on 2018-01-11T18:00:30Z (GMT). No. of bitstreams: 1 ROSA_MELISSA_CORTES_DISSERTAÇÃO.pdf: 1811235 bytes, checksum: a5445306dcac7e5c2d450aadcdf48c11 (MD5) Previous issue date: 2016-03-28Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/170664/ROSA_MELISSA_CORTES_DISSERTA%c3%87%c3%83O.pdf.jpghttp://tede2.pucrs.br:80/tede2/retrieve/170674/DIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.jpghttps://tede2.pucrs.br/tede2/retrieve/186236/DIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em Gerontologia BiomédicaPUCRSBrasilEscola de MedicinaIdosoEstado NutricionalDesnutriçãoCIENCIAS DA SAUDE::MEDICINAValidade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizadosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTrabalho será publicado como artigo ou livro60 meses10/01/20134438661476953179033500600500600-224747486637135387-9693694523087866272075167498588264571info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSORIGINALDIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdfDIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdfapplication/pdf1811235https://tede2.pucrs.br/tede2/bitstream/tede/7804/5/DIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdfa5445306dcac7e5c2d450aadcdf48c11MD55THUMBNAILDIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.jpgDIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.jpgimage/jpeg4107https://tede2.pucrs.br/tede2/bitstream/tede/7804/4/DIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.jpg5504ac6c510879d1d775bbd42d1f3b54MD54DIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.jpgDIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.jpgimage/jpeg5938https://tede2.pucrs.br/tede2/bitstream/tede/7804/7/DIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.jpg4ccf838e86adf7b676bda7967668d723MD57TEXTDIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.txtDIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.txttext/plain3235https://tede2.pucrs.br/tede2/bitstream/tede/7804/3/DIS_MELISSA_CORTES_DA_ROSA_CONFIDENCIAL.pdf.txtcf22235a335a47477e5065ef84edca56MD53DIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.txtDIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.txttext/plain149360https://tede2.pucrs.br/tede2/bitstream/tede/7804/6/DIS_MELISSA_CORTES_DA_ROSA_COMPLETO.pdf.txt7579e45e647b3ab5c8fa851b56e1a265MD56LICENSElicense.txtlicense.txttext/plain; charset=utf-8610https://tede2.pucrs.br/tede2/bitstream/tede/7804/1/license.txt5a9d6006225b368ef605ba16b4f6d1beMD51tede/78042023-01-13 20:00:12.595oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2023-01-13T22:00:12Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
title |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
spellingShingle |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados Rosa, Melissa Côrtes da Idoso Estado Nutricional Desnutrição CIENCIAS DA SAUDE::MEDICINA |
title_short |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
title_full |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
title_fullStr |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
title_full_unstemmed |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
title_sort |
Validade da força de preensão palmar isolada e combinada com a mini avaliação nutricional na identificação do risco de desnutrição em idosos hospitalizados |
author |
Rosa, Melissa Côrtes da |
author_facet |
Rosa, Melissa Côrtes da |
author_role |
author |
dc.contributor.author.fl_str_mv |
Rosa, Melissa Côrtes da |
dc.contributor.advisor1.fl_str_mv |
Schwanke, Carla Helena Augustin |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4707856Y2 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4165730A0 |
contributor_str_mv |
Schwanke, Carla Helena Augustin |
dc.subject.por.fl_str_mv |
Idoso Estado Nutricional Desnutrição |
topic |
Idoso Estado Nutricional Desnutrição CIENCIAS DA SAUDE::MEDICINA |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Background: Malnutrition prevalence in hospitalized elderly varies between 2 and 80%, depending on a diversity of factors involved in the diagnosis, such as the heterogeneity of the elderly population, place where they live and diagnostic criteria used. Moreover, malnutrition etiology is multifactorial, leading to an increased morbidity and mortality. Researchers have recently proposed the use of the hand grip strength (HGS) for the nutritional state screening, due to its simple, rapid and low-cost application. This proposal was based on previous studies demonstrating that malnutrition leads to atrophy of type II muscle fibers and alterations of the Z band, reducing strength even before changes in anthropometric measurements can be observed. Aim: The aims of the present study were: (1) to determine the validity of HGS isolated and combined with the Mini Nutritional Assessment (MNA®) and Mini Nutritional Assessment-short form (MNA®-SF) in the malnutrition risk identification in hospitalized elderly; (2) to analyze the association of HGS with sociodemographic, anthropometric, medical clinical variables, nutritional status and malnutrition risk; (3) to determine a HGS cutoff value for malnutrition risk identification.Methods: This was a cross-sectional and analytical study that involved the evaluation of 281 hospitalized elderly patients in a university hospital in Porto Alegre/Brazil. The investigated population was composed of clinical and surgical patients that were able to perform the HGS assessment by means of the Jamar® dynamometer. The nutritional status was determined through the Global Subjective Assessment (GSA) and the malnutrition risk was evaluated through the MNA® and MNA®-SF. The HGS association and correlation analysis with the sociodemographic, anthropometric and medical variables, as well as the nutritional status and nutritional risk, were performed through the Mann-Whitney test, Kruskal-Wallis followed by SNK, and Spearman’s correlation. For the ROC curves regarding the HGS associated with the GSA, and determination of the HGS accuracy when isolated or combined with MNA® and MNA®-SF, two categories were considered: eutrophic and at malnutrition risk/malnourished. Results: The majority of the evaluated elderly patients were males (58.0%), with a mean age of 69.1±6.6 years old (60-94 years old). The prevalence of nutritional risk/malnutrition was 44.5% according to GSA, 51.2% by MNA® and 66.2% by MNA®-SF. Median HGS was significantly lower in females [9.17 kg (6.00-21.42) versus 19.67 kg (14.67-24.33); P<0.001], in individuals ≥80 years old [12.67 (7.33-19.33) versus 16.00 kg (10.00-22.08); P<0.001]; and with low-income [13.17 kg (8.00-20.00) versus 19.50 kg (14.42-26.58); P<0.001]. HGS was significantly associated with the nutritional status (P<0.001). Mean HGS was significantly higher in eutrophic individuals when compared to malnourished individuals (evaluated by the three nutritional status instruments). HGS combined with MNA® or MNA®-SF showed a higher sensitivity (93.6 %; IC95%: 0.833-0. 969 and 98.4%; IC95%: 0.943-0.997, respectively) than did HGS isolated (63.2%; IC95%: 0.563-0.698) in malnutrition risk identification. Conclusion: In summary, HGS can be considered a sensitive tool in the malnutrition screening in hospitalized elderly patients when combined with MNA® or MNA®-SF. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016-03-28 |
dc.date.accessioned.fl_str_mv |
2018-01-11T18:00:30Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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http://tede2.pucrs.br/tede2/handle/tede/7804 |
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http://tede2.pucrs.br/tede2/handle/tede/7804 |
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por |
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info:eu-repo/semantics/openAccess |
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application/pdf |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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Programa de Pós-Graduação em Gerontologia Biomédica |
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PUCRS |
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Brasil |
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Escola de Medicina |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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MD5 MD5 MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
repository.mail.fl_str_mv |
biblioteca.central@pucrs.br|| |
_version_ |
1799765330476662784 |