PRE-SURGICAL NUTRITIONAL STATUS AND SURGICAL COMPLICATIONS IN PATIENTS WITH DIGESTIVE AND HEAD AND NECK CANCER

Isabel Ruivo; Carolina Castro; Ana Gonçalves; Paula Alves; Daniel Moreira-Gonçalves; Lúcio Lara Santos

doi:10.34635/rpc.931

Isabel Ruivo Nutrition Service, Portuguese Institute of Oncology, Porto, Portugal
Carolina Castro Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
Ana Gonçalves Nutrition Service, Portuguese Institute of Oncology, Porto, Portugal
Paula Alves Nutrition Service, Portuguese Institute of Oncology, Porto, Portugal
Daniel Moreira-Gonçalves Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal http://orcid.org/0000-0002-7404-7405
Lúcio Lara Santos Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal; Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal; Surgical Intermediate Care Unit, Portuguese Institute of Oncology, Porto, Portugal http://orcid.org/0000-0002-7404-7405

Resumo

Introdução: A desnutrição está presente em 40-50% dos doentes cirúrgicos no momento da admissão hospitalar, sendo considerada um dos fatores que mais influencia a morbimortalidade pós-cirúrgica. É importante estabelecer rotinas para identificar e monitorizar os doentes em risco nutricional, para iniciar a terapia nutricional precocemente, idealmente na fase pré-cirúrgica. O objetivo do presente trabalho foi avaliar a associação entre estado nutricional pré-cirúrgico e as complicações pós-cirúrgicas e verificar qual o instrumento de avaliação nutricional com melhor valor prognóstico para complicações pós-cirúrgicas, em doentes encaminhados para vigilância para as unidades de cuidados intermédios e intensivos durante o planeamento cirúrgico.

Métodos: Foram recrutados doentes nas Unidades de Patologia Digestiva e de Cabeça e Pescoço, que tinham sido encaminhados para cirurgia e sinalizados na consulta de anestesia para vigilância pós-cirúrgica em Terapia Intermediária ou Intensiva, de agosto a dezembro de 2016, no Instituto Português de Oncologia do Porto, Francisco Gentil, EPE. Dados clínicos e demográficos foram recolhidos através de consulta ao processo clínico. A avaliação do risco e do estado nutricional foi realizada através do PG-SGA e do NRI, nas primeiras 24 horas da admissão do doente para internamento hospitalar. A análise dos dados foi realizada através do programa estatístico SPSS 23.0.

Resultados: Foram incluídos 97 doentes, 62 com neoplasias digestivas e 35 com neoplasias malignas de cabeça e pescoço. A prevalência de desnutrição pré-cirúrgica avaliada foi de 51,2% e 33%, avaliada pelo NRI e PG-SGA, respetivamente. O estado nutricional, avaliado pelo NRI, foi associado a complicações pós-operatórias e maior tempo de hospitalização. O estado nutricional e a falta de suporte nutricional também foram associados a maior risco de hospitalização prolongada (> 10 dias).

Conclusão: O risco de desenvolver complicações pós-cirúrgicas foi cerca de 3 vezes maior em doentes desnutridos ou em risco de desnutrição avaliados pelo NRI.

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ESTADO NUTRICIONAL PRÉ-OPERATÓRIO E COMPLICAÇÕES CIRÚRGICAS EM DOENTES COM CANCRO DIGESTIVO E DA CABEÇA E PESCOÇO

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