Fontes Daniel, Generoso Simone de Vasconcelos, Toulson Davisson Correia Maria Isabel
Critical Care Unit, Hospital Felício Rocho, Belo Horizonte, MG, Brazil.
Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Clin Nutr. 2014 Apr;33(2):291-5. doi: 10.1016/j.clnu.2013.05.004. Epub 2013 May 13.
BACKGROUND & AIMS: Nutritional assessment of critically ill patients has created controversy. However, it is well established that malnourished patients who are severely ill have worse outcomes than well-nourished patients. Therefore, assessing patients' nutritional status may be useful in predicting which patients may experience increased morbidity and mortality.
One hundred eighty-five consecutively admitted patients were followed until discharge or death, and their nutritional status was evaluated using Subjective Global Assessment (SGA) as well as anthropometric and laboratory methods. Agreement between the methods was measured using the Kappa coefficient.
Malnutrition was highly prevalent (54%), according to SGA. Malnourished patients had significantly higher rates of readmission to the intensive care unit (ICU) (OR 2.27; CI 1.08-4.80) and mortality (OR 8.12; CI 2.94-22.42). The comparison of SGA with other tests used to assess nutritional status showed that the correlation between the methods ranged from poor to superficial.
SGA, an inexpensive and quick nutritional assessment method conducted at the bedside, is a reliable tool for predicting outcomes in critically ill patients.
危重症患者的营养评估存在争议。然而，众所周知，重症营养不良患者的预后比营养良好的患者更差。因此，评估患者的营养状况可能有助于预测哪些患者的发病率和死亡率可能增加。
对185例连续入院的患者进行随访直至出院或死亡，并采用主观全面评定法（SGA）以及人体测量和实验室方法评估他们的营养状况。使用Kappa系数测量这些方法之间的一致性。
根据SGA，营养不良非常普遍（54%）。营养不良患者再次入住重症监护病房（ICU）的发生率（比值比2.27；可信区间1.08 - 4.80）和死亡率（比值比8.12；可信区间2.94 - 22.42）显著更高。SGA与用于评估营养状况的其他测试的比较表明，这些方法之间的相关性从较差到表面相关不等。
SGA是一种在床边进行的廉价且快速的营养评估方法，是预测危重症患者预后的可靠工具。
