NUTRITIONAL STATUS AND FACTORS ASSOCIATED WITH GRIP STRENGTH IN ELDERLY CANDIDATES FOR SURGERY
DOI:
https://doi.org/10.34635/rpc.857Keywords:
nutritional assessment, muscle strength, aged, fasting, elective surgical proceduresAbstract
Background: nutritional assessment in surgical elderly is important to identify individuals at risk for surgical complications and intervene in a timely manner.
Objective: to assess nutritional status and factors associated with handgrip strength in pre- surgical elderly.
Methods: cross-sectional study, with elderly candidates for elective surgery, in a tertiary hospital in the State of Pernambuco, Brazil. Sociodemographic, clinical, nutritional and physical activity variables were collected. To assess nutritional risk, NRS-2002 was carried out; for nutritional diagnosis, body mass index, weight loss percentage, arm and calf circumference were collected, and handgrip strength was used to assess muscle strength.
Results: 105 patients were studied, 52.4% women and 80% with benign diseases. The diagnosis of eutrophy, according to the body mass index, arm circumference and calf circumference was prevalent in 44.8%, 60% and 66.7% of the elderly, respectively. The handgrip strength was adequate in 82.9%, and lower values were associated with advanced age (p = 0.039), female sex (p <0.001), being single or widowed (p <0.001), physical inactivity (p = 0.001), nutritional risk (p = 0.038) and malnutrition due to calf circumference (p = 0.046). The preoperative fasting time was 11.96 ± 2.65 hours and in the postoperative period 4.73 ± 6.29 hours. The prevalent clinical outcome was hospital discharge (99%), with mortality occurring in one patient. The length of stay was 1-2 days in 76.2%.
Conclusions: there was a low frequency of nutritional risk and malnutrition. Nutritional risk and malnutrition according to calf circumference were related to lower values of handgrip strength, in addition to advanced age, being single or widowed and sedentary, with a significant association between reduced muscle strength and these conditions. Malignant diseases and major surgeries were associated with an unfavorable clinical outcome, longer hospital stay and the presence of nutritional risk.
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2. Lucchesi FA, Gadelha PCFP. Estado nutricional e avaliação do tempo de jejum perioperatório de pacientes submetidos à cirurgias eletivas e de emergência em um hospital de referência. Rev Col Bras Cir. 2019; 46(4). http://dx.doi.org/10.1590/0100-6991e-20192222.
3. Gillis C, Carli F. Promoting perioperative metabolic and nutritional care. Anesthesiology. 2015; 123(6):1455-72. https://doi.org/ 10.1097/ALN.0000000000000795.
4. Aguilar-Nascimento JE, Salomão AB, Waitzberg DL, Dock-Nascimento DB, Correa MITD, Campos ACL, Corsi PR, Filho PEP, Caporossi C. Diretriz ACERTO de intervenções nutricionais no perioperatório em cirurgia geral eletiva. Rev Col Bras Cir. 2017; 44(6):633-648. http://dx.doi.org/10.1590/0100-69912017006003.
5. Santos HVD, Araujo CMS. Estado nutricional pré – operatório e incidência de complicações cirúrgicas em pacientes idosos do Estado de Pernambuco (Brasil) submetidos a cirurgias gastrointestinais. Nutr Clín Diet Hosp. 2014; 34(1):41-49. http://dx.doi.org/ 10.12873/341santos
6. Carvalho, ESV, Leão ACM, Bergmann A. Funcionalidade de pacientes com neoplasia gastrointestinal alta submetidos ao tratamento cirúrgico em fase hospitalar. ABCD Arq Bras Cir Dig. 2018; 31(1):1353. http://dx.doi.org/10.1590/0102-672020180001e1353
7. Martin FG, Nebuloni CC, Najas MS. Correlação entre estado nutricional e força de preensão palmar em idosos. Rev Bras Geriatr Gerontol. 2012; 15(3):493-504. https://doi.org/10.1590/S1809-98232012000300010
8. Lenardt MH, Carneiro NHK, Betiolli SE, Binotto MA, Ribeiro DKMN, Teixeira FFR. Fatores associados à força de preensão manual diminuída em idosos. Esc Anna Nery. 2016;20(4):2016-82. https://doi.org/10.5935/1414-8145.20160082.
9. Silveira TMG, Sousa JB, Stringhini MLF, Freitas ATVS, Melo PG. Avaliação nutricional e força de aperto de mão de candidatos à cirurgia do trato gastrointestinal. ABCD Arq Bras Cir Dig. 2014;27(2):104-108. https://doi.org/10.1590/S0102-67202014000200005.
10. Limberger VR, Pastore CA, Abib RT. Associação entre dinamometria manual, estado nutricional e complicações pós-operatórias em pacientes oncológicos. Rev Bras Cancerol. 2014; 60(2):135-141. https://doi.org/10.32635/2176-9745.RBC.2014v60n2.479.
11. Reis CB, Jesus RS, Silva CSO, Pinho L. Condições de saúde de idosos jovens e velhos. Rev Rene. 2016 jan-fev; 17(1):120-7.
12. Kondrup J,Allison SP; Elia M, Vellas B, Plauth M. ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr. 2003; 22(4):415-421.
13. Lohman TG, Roche AF, Martorell R. Antropometric standardization reference manual. Abridged Edition. Illinois: Human Kinetics Books; 1988.
14. Blackburn GL, Thornton PA. Nutritional assessment of the hospitalized patient. Med Clin North Am. 1979; 63(5):11103-15.
15. Chumlea WC, Guo SS, Steinbaugh ML. Prediction of stature from knee height for black and white adults and children with application to mobility-impaired or handicapped persons. J Am Diet Assoc. 1994; 94(12):1385-8.
16. Lipschitz DA. Screening for nutritional status in the elderly. Prim Car. 1994; 21(2): 55-67.
17. Kuczmarski MF, Kuczarisk RJ, Najjar M. Descriptive anthropometric reference data for older Americans. J Am Diet Assoc 2000; 100:59-66.
18. Pagotto V, Santos KF, Malaquias SG, Bachion MM, Silveira EA. Calf circumference: clinical validation for evaluation of muscle mass in the elderly. Rev Bras Enferm [Internet]. 2018;71(2):322-8. https://doi.org/10.1590/0034-7167-2017-0121
19. Fess EE. Grip strength. In: Casanova JS. Clinical Assessment Recommendations. 2nd ed. Chicago: American Society of Hand Therapists, 1992:41-45.
20. Mendes J, Azevedo A, Amaral TF. Força de preensão da mão – quantificação, determinantes e utilidade clínica. Arq Med. 2013;27(3):115-120.
21. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age ageing. 2019; 48(1):16-31. https://doi.org/10.1093/ageing/afy169.
22. Dias CA, Burgos MGPA. Diagnóstico nutricional de pacientes cirúrgicos. ABCD Arq Bras Cir Dig. 2009;22(1):2-6. https://doi.org/10.1590/S0102-67202009000100002
23. Waitzberg DL, Caiaffa WT, Correia ITD. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutr. 2001; 17(7-8):573-80. https://doi.org/10.1016/s0899-9007(01)00573-1.
24. Soares BLM, Burgos MGPA. Nutritional risk among surgery patients and associations with hospital stay and postoperative complications. Nutr Hosp. 2014;30:636-642. . https://doi.org/10.3305/nh.2014.30.3.7633.
25. Bazzi NB, Leal V, Lira FHJ, Santos JM, Ferreira MG, Zeni, LAZR. Estado nutricional e tempo de jejum em pacientes submetidos a cirurgias colorretais eletivas. Nutr Clín Diet Hosp. 2016; 36(2):103-110.
26. Martinez BP, Ramos IR, Oliveira QC, Santos RA, Marques MD, Júnior LAF, Camelier FWR, Camelier AA. Existe associação entre massa e força muscular esquelética em idosos hospitalizados? Rev Bras Geriatr Gerontol. 2016; 19(2):257-264. https://doi.org/10.1590/1809-98232016019.140228
27. Peixoto LG, Barbosa CD, Nahas PC, Rossato LT, Oliveira ER. A circunferência da panturrilha está associada com a massa muscular de indivíduos hospitalizados. Rev Bras Nutr Clin. 2016; 31(2):167-71.
28. Falsarella GR, Gasparotto LPR, Barcelos CC, Coimbra IB, Moretto MC, Pascoa MA, Ferreira TCBR, Coimbra AMV. Body composition as a frailty marker for the elderly community. Clin Interv Aging. 2015; 10: 1661–1667. https://doi.org/10.1590/10.2147/CIA.S84632.
29. Mattioli RA, Cavalli AS, Ribeiro JAB, Silva MC. Associação entre força de preensão manual e atividade física em idosos hipertensos. Rev Bras Geriatr Gerontol. 2015; 18(4):881-891. https://doi.org/10.1590/1809-9823.2015.14178.
30. Silva NA, Pedraza DF, Menezes TN. Desempenho funcional e sua associação com variáveis antropométricas e de composição corporal em idosos. Ciênc Saúde Coletiva [online]. 2015; 20(12):3723-3732. https://doi.org/10.1590/1413-812320152012.01822015.
31. Aguilar-Nascimento JE, Dias ALA, Dock-Nascimento DB, Correia MITD, Campos ACL, Filho PEP, Oliveira SS. Actual preoperative fasting time in Brazilian hospitals: the BIGFAST multicenter study. Ther Clin Risk Manag. 2014; 10:107–112. https://doi.org/10.2147/TCRM.S56255
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