Thieme Rubia Daniela, Cutchma Gislaine, Chieferdecker Maria Eliana Madalozzo, Campos Antônio Carlos Ligocki
Arq Bras Cir Dig. 2013 Nov-Dec;26(4):286-92. doi: 10.1590/s0102-67202013000400007.
Malnutrition can be considered the most common disease in hospitals due to its high prevalence.
To investigate the methods of evaluation of the nutritional status that better correlate with postoperative complications and the length of hospital stay in patients submitted to gastrointestinal or abdominal wall surgeries.
This is a retrospective evaluation of 215 nutritional assessment records. All were submitted to traditional anthropometry (weight, height, BMI, arm circumference, triceps skinfold thickness and mid-arm muscle circumference), subjective global assessment, serum albumin and lymphocyte count. Nutritional risk index was also calculated.
A total of 125 patients were included. Malnutrition was diagnosed by mid-arm muscle circumference, nutritional risk index and subjective global assessment in 46%, 88% and 66%, respectively. Severe malnutrition was found in 17,6% if considered subjective global assessment and in 42% by the nutritional risk index. Oncologic patients had a worst nutritional status according to this index (5,42 less units). There was a negative correlation between occurrence the noninfectious postoperative complications with the nutritional risk index (p=0,0016). Similarly, lower serum albumin levels were associated with higher non infectious complications (p=0,0015). The length of hospital stay was, in average, 14,24 days less in patients without complications as compared with non infectious postoperative complications (p<0,05).
Nutritional risk index and serum albumin are the parameters with the best capacity to predict the occurrence of non infectious postoperative complications and the length of hospital stay was higher to this patients.
营养不良因其高患病率可被视为医院中最常见的疾病。
研究与接受胃肠或腹壁手术患者术后并发症及住院时间更具相关性的营养状况评估方法。
这是一项对215份营养评估记录的回顾性评估。所有记录均接受传统人体测量学（体重、身高、体重指数、臂围、三头肌皮褶厚度和上臂中部肌肉周长）、主观全面评定、血清白蛋白和淋巴细胞计数评估。还计算了营养风险指数。
共纳入125例患者。分别通过上臂中部肌肉周长、营养风险指数和主观全面评定诊断出营养不良的患者比例为46%、88%和66%。若采用主观全面评定，17.6%的患者存在严重营养不良；若采用营养风险指数，则为42%。根据该指数，肿瘤患者的营养状况最差（低5.42个单位）。术后非感染性并发症的发生与营养风险指数呈负相关（p = 0.0016）。同样，血清白蛋白水平较低与较高的非感染性并发症相关（p = 0.0015）。与术后有非感染性并发症的患者相比，无并发症患者的平均住院时间少14.24天（p < 0.05）。
营养风险指数和血清白蛋白是预测术后非感染性并发症发生及该类患者住院时间的最佳参数。
