Hospital e Maternidade Municipal de São José dos Pinhais, São José dos Pinhais, Paraná, Brazil.
Instituto Cristina Martins de Educação e Pesquisa em Saúde, Faculdade Inspirar, Curitiba, Paraná, Brazil.
Nutr Clin Pract. 2021 Oct;36(5):993-1002. doi: 10.1002/ncp.10637. Epub 2021 Mar 9.
This study aimed to validate the Malnutrition Clinical Characteristics (MCC) compared with the Subjective Global Assessment (SGA), considering anthropometric measures, comorbidities, and mortality in critically ill patients.
This longitudinal observational study included patients admitted to the general intensive care unit (ICU) of a public hospital. SGA was used as the reference standard for diagnosing malnutrition. The inclusion criteria were patients receiving nutrition support therapy and age >18 years. The nutrition therapy was optimized as close as possible to 100% of the patients' energy and protein needs regardless of the access route. Hospital length of stay (LOS), comorbidities on admission, and death were documented during the entire hospitalization of each patient. Body mass index (BMI), midarm circumference (MAC), and calf circumference (CC) were considered anthropometric measures.
The convenience sample comprised 102 ICU patients. Comparing the original malnutrition classifications of SGA with MCC, the specificity was 87.5%, sensitivity was 100%, accuracy was 93.3%, positive predictive value was 87.5%, and negative predictive value was 100%. When classified in 2 groups, namely "well-nourished" and "malnourished," specificity and sensitivity were 100% between both groups. Malnourished patients had significantly higher mortality rates (P = .006) and longer LOSs (P <.001). As expected, BMI, MAC, and CC results were similar for SGA and MCC.
MCC was a valid tool for classifying malnutrition in ICU patients. Because the evaluation is fast and does not require expensive equipment that is difficult to handle, it is believed to be practical, low-cost, and easy to use.
本研究旨在验证营养不良临床特征（MCC）与主观全面评估（SGA）相比，考虑到危重症患者的人体测量学指标、合并症和死亡率。
这是一项纵向观察性研究，纳入了一家公立医院综合重症监护病房（ICU）收治的患者。SGA 被用作诊断营养不良的参考标准。纳入标准为接受营养支持治疗且年龄>18 岁的患者。无论途径如何，都将营养治疗优化至尽可能接近满足患者 100%的能量和蛋白质需求。记录每位患者整个住院期间的住院时间（LOS）、入院时的合并症和死亡情况。体重指数（BMI）、上臂中部周长（MAC）和小腿周长（CC）被视为人体测量学指标。
方便抽样纳入了 102 例 ICU 患者。将 SGA 的原始营养不良分类与 MCC 进行比较，特异性为 87.5%，敏感性为 100%，准确性为 93.3%，阳性预测值为 87.5%，阴性预测值为 100%。当分为“营养良好”和“营养不良”两组时，两组之间的特异性和敏感性均为 100%。营养不良患者的死亡率显著更高（P=.006），住院时间更长（P<.001）。与预期一致，SGA 和 MCC 的 BMI、MAC 和 CC 结果相似。
MCC 是一种用于分类 ICU 患者营养不良的有效工具。由于评估快速且不需要难以操作的昂贵设备，因此被认为实用、低成本且易于使用。
