ESTADO NUTRICIONAL DE PACIENTES HOSPITALIZADOS COM NEOPLASIA DO TRATO GASTROINTESTINAL NO PERÍODO PERIOPERATÓRIO

• Autor(a) principal: Golin, Anieli
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional Universidade Franciscana
• Texto Completo: http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/878
• topic: Avaliação nutricional; Cuidados perioperatórios; Desnutrição; Hospitalização; Jejum pós-operatório; Terapia nutricional.; Nutrition assessment; Perioperative care; Malnutrition; Hospitalization; Postoperative fasting; Nutrition therapy.; Ciências da Saúde e da Vida

Introduction: Surgical patients with gastrointestinal tract neoplasia often suffer from malnutrition. Objective: To evaluate the nutritional status of hospitalized patients with gastrointestinal tract neoplasia in the perioperative period. Methods: A quantitative, longitudinal, and prospective study performed at the surgical unit in a public reference hospital in the city of Santa Maria, RS, Brazil, from August 2018 to August 2019. Patients undergoing surgery for upper (mouth, pharynx, esophagus and stomach) and lower (small and large intestines, rectum and anus) gastrointestinal tract neoplasia were followed in the perioperative period, male and female, aged 18 years or older. Data collection was performed through an interview and follow-up with patients and caregivers, and by monitoring the electronic medical record used by the hospital staff. Follow-up started within 72 hours after hospitalization admission, and re-evaluation was performed 72 hours after the surgical procedure. Were collected data, such as gender, age, type and size of surgery, preoperative and postoperative fasting time, average length of stay, and nutritional monitoring through anthropometric assessment, Subjective Global Assessment, hand grip strength, adductor pollicis muscle thickness, dietary assessment through dietary record (acceptance and usual dietary analysis and during the perioperative period, and follow-up of preparations at the hospital's Nutrition and Dietetic Service) and laboratory tests. Two original articles were written. Statistical analysis was performed using t-tests, Wilcoxon, chi-square test, Pearson and Spearman correlations, which were considered statistically significant when p < 0.05. Results: In the first article, it was observed that the used average preoperative fasting time in the upper gastrointestinal tract (8.2 ± 2.8 hours) and low gastrointestinal tract (8.1 ± 2.2 hours) groups was according to the literature; however, in the postoperative period, both the upper gastrointestinal tract (60.4 ± 40.7 hours) and the lower gastrointestinal tract (57.65 ± 38.19 hours) average fasting time was statistically longer than 24 hours (p < 0.001). Although eutrophic, in the preoperative period, it was observed in both groups that most patients had severe weight loss, muscle depletion, anemia, hypoalbuminemia, and low dietary acceptance, especially of the upper gastrointestinal tract. In the second article, it was observed that the dietary intake of calories, carbohydrates, proteins, lipids, selenium, zinc and copper during the perioperative period was lower than usual in both groups, especially in the upper gastrointestinal tract group. Although adults were considered overweight and elderly eutrophic in the preoperative period by Body Mass Index, it was observed in both groups that most patients had malnutrition and muscle depletion by Subjective Global Assessment, anemia, hypoalbuminemia and serum iron levels, especially in the upper gastrointestinal tract group. Conclusions: Low dietary intake and prolonged fasting during the perioperative period aggravate the nutritional status of surgical patients with gastrointestinal tract neoplasia. Thus, it is essential to identify whether patients are malnourished or at risk of malnutrition so that this condition can be mitigated or improved, and when possible, even before the beginning of the surgical procedure.