remeReme: Revista Mineira de EnfermagemReme : Rev. Min. Enferm.1415-27622316-9389Escola de Enfermagem da Universidade Federal de Minas Gerais-UFMGBelo Horizonte, MG, BrazilS1415-27622013000300013S1415-2762(13)0170031310.5935/1415-2762.20130048PesquisasDesfecho terapêutico de pacientes em risco nutricional admitidos em um hospital universitárioTherapeutic outcome of patients at nutritional risk upon admission to a university hospitalDesenlace terapéutico de pacientes en riesgo de desnutrición ingresados en un hospital universitarioJansenAnn KristineSilveiraAna Letícia MalheirosOliveiraMarcella Amorim Braga dePimentaAdriano MarçalBelo HorizonteMGUFMGEscola de Enfermagem Departamento Materno Infantil e Saúde PúblicaBrasilBelo HorizonteMGHospital Municipal Odilon BehrensPrograma de Residência Multiprofissional BrasilBelo HorizonteMGUFMGInstituto de Ciências Biológicas Programa de Pós-GraduaçãoBrasilBelo HorizonteMGUniversidade Federal de Minas GeraisEscola de Enfermagem Departamento de Enfermagem BásicaBrasil0920131736516572608201309082012This work is licensed under a Creative Commons Attribution 4.0 International License.Full text available only in PDF format (EN)Texto completo somente em PDF (PT)

OBJETIVO: investigar a influência do risco nutricional, detectado ao início da internação, no desfecho terapêutico de pacientes. MÉTODOS: estudo de coorte prospectiva com 495 pacientes admitidos no pronto-atendimento de um hospital universitário, submetidos à triagem de risco nutricional com base no Nutritional Risk Screening, 2002. Ao final da internação, buscaram-se os prontuários para avaliação do desfecho, complicações e presença da terapia nutricional. RESULTADOS: do total de pacientes, 53,9% eram do sexo feminino, 71,3% tinham idade inferior a 60 anos e 11,7% evoluíram com cuidados paliativos/óbito. Segundo o índice de massa corporal, 15,5% dos pacientes foram classificados como desnutridos. O risco nutricional foi encontrado em 54,5% e associou-se fortemente ao desfecho terapêutico cuidados paliativos/óbito (HR: 5,92; IC 95%: 2,68-13,08), assim como seus componentes, estresse metabólico da doença (HR: 3,33; IC 95º%: 1,61-6,86) e estado nutricional prejudicado (moderado = HR: 3,24; IC 95º%: 1,31-8,00; grave = HR: 6,45; IC 95%: 2,36-17,63), após o ajuste por potenciais fatores de confusão. CONCLUSÃO: a prevalência de risco nutricional detectada foi alta e sua presença estava relacionada a pior desfecho terapêutico.

OBJECTIVE: to investigate the influence of nutritional risk, detected upon being admitted to a hospital, on therapeutic outcomes in patients. METHODS: This prospective cohort study was conducted with 495 patients admitted to the emergency clinic of a public hospital, where they were screened for nutritional risk based on the Nutritional Risk Screening 2002. At the end of hospitalization, the outcome, complications, and the presence of nutritional therapy were evaluated based on the medical records. RESULTS: Of the total patients, 53.9% were female, 71.3% were less than 60 years of age, and 11.7% had the therapeutic outcome of palliative care / death. According to Body Mass Index (BMI), 15.5% of the patients were classified as malnourished. Nutritional risk was found in 54.5%, which correlated strongly with the therapeutic outcome of palliative care/death (HR: 5.92, 95% CI: 2.68 to 13.08) as well as their components of increased nutritional requirements (HR: 3.33, 95% CI: 1.61 to 6.86) and impaired nutritional status (HR = moderate: 3.24, 95% CI: 1.31 to 8.00, severe = HR: 6.45, 95% CI: 2.36 to 17.63) after adjustment for potential confounding factors. CONCLUSION: The prevalence of nutritional risk detected in the sample was high, and its presence was related to a poor therapeutic outcome.

El objetivo del presente estudio fue investigar la influencia del riesgo de nutrición detectado al inicio de la hospitalización en el desenlace terapéutico de pacientes. Se trata de un estudio de cohorte prospectivo llevado a cabo con 495 pacientes ingresados en el Servicio de Urgencias de un hospital universitario. Los pacientes fueran evaluados sobre el riesgo de desnutrición en base al Nutritional Risk Screening 2002. Al final de la hospitalización se buscaron los registros médicos para evaluar el desenlace, las complicaciones y la terapia nutricional. El 53,9% de los pacientes era del sexo femenino, el 71,3% menor de 60 años, un 11,7% evolucionó con cuidados paliativos o falleció. De acuerdo con el índice de masa corporal, el 15,5% de los pacientes fue clasificado como desnutrido. Se detectó riesgo nutricional en un 54,5%, bastante asociado al desenlace terapéutico, derivado en cuidados paliativos u óbito (HR: 5,92, IC del 95%: 2,68 a 13,08), así como sus componentes, estrés metabólico de la enfermedad (HR: 3,33, IC del 95%: 1,61 a 6,86) y estado nutricional alterado (moderado = HR: 3,24, IC del 95%: 1,31 a 8,00; HR = grave: 6,45, IC del 95%: 2,36 a 17,63), después del ajuste por posibles factores de confusión. La prevalencia de riesgo de nutrición detectada fue alta y su presencia asociada al peor desenlace terapéutico.

Nutritional AssessmentOutcomeInpatientsRiskScreeningEvaluación NutricionalEvaluación de Resultado (Atención de Salud)Pacientes InternosRiesgoTriajeAvaliação NutricionalDesfechoPacientes InternadosRiscoTriagem
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