medigraphic.com
ISSN 1729-519X (Print)

2020, Number 4

<< Back Next >>

Revista Habanera de Ciencias Médicas 2020; 19 (4)

Assessment of nutritional status in critical ill patients by means of two Nutritional Risk Indexes

Larrondo MHM, León PDO, Ginarte RLM, Gutiérrez RÁR

Language: Spanish
References: 31
Page: 1-14
PDF size: 841.60 Kb.


ABSTRACT

Introduction: Nutritional status markers that better stratify risk in critically ill patients have yet to be established.
Objective: To assess nutritional risk in critically ill patients through the use of two assessment scales.
Material and Methods: A prospective descriptive cross-sectional study was conducted in 222 patients admitted to the Intensive Care Unit (8B) at the “Hermanos Ameijeiras” Hospital from September, 2017 to May, 2018. The Controlling Nutritional Status (CONUT) and the modified Nutrition Risk in the Critically ill (mNutric) were used.
Results: According to CONUT, 96.4% of patients were malnourished; according to mNutric, 27.5% of patients were categorized as high nutritional risk. There was an association between the scales (Kappa = 0.102). Among survivors, 78.3% of patients were at low risk according to mNutric score (p=0,013). There was an association between sepsis and malnutrition due to mNutric (p = 0.013) versus artificial mechanical ventilation (AMV) and malnutrition estimated by this scale (p = 0.116). No differences were found between sepsis and malnutrition according to CONUT (p = 0.126). There were differences between the AMV in relation to malnutrition according to CONUT score (p = 0.027). The frequency of deaths increased in parallel to the degree of malnutrition according to CONUT (p = 0.004). AMV was the variable that most influenced mortality (OR = 8,5).
Conclusions: According to CONUT, most of the patients were malnourished; according to mNutric, patients at low nutritional risk predominated. The predictive value of death in patients receiving AMV was demonstrated. The light and moderate malnutrition and the variable related with the not malnourished group (CONUT scale) were considered as categories associated with lower risk of death with regard to severe malnutrition.


REFERENCES

  1. Campos del Portillo R, Palma S, García N, Riobó P, García Luna P, Gómez Candela C. Valoración del estado nutricional en el entorno asistencial en España. Rev Esp Nutr Comunitaria [Internet]. 2015 [Citado 23/02/2019]; 21(1):195-206. Disponible en: Disponible en: http://renc.es/imagenes/auxiliar/files/NUTR.%20COMUN.%20SUPL.%201-2015_valoracion%20asistencial.pdf

  2. Vanderwee K, Clays E, Bocquaert I, Gobert M, Folens B, Defloor T. Malnutrition and associated factors in elderly hospital patients: a Belgian cross-sectional, multi-centre study. Clin Nutr [Internet]. 2010 [Citado 20/05/2019];29(4):469-76. Disponible en: Disponible en: https://biblio.ugent.be/publication/836286

  3. Orsitto G, Fulvio F, Tria D, Turi V, Venezia A, Manca C. Nutritional status in hospitalized elderly patients with mild cognitive impairment. Clin Nutr. 2009;28(1):100-2.

  4. Hébuterne X, Lemarié E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral Nutr [Internet]. 2014 [Citado 20/05/2019];38(2):196-204. Disponible en: Disponible en: https://europepmc.org/article/med/24748626

  5. Planas M, Álvarez J, León M, Celaya S, Araujo K, García A, et al. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer [Internet]. 2016 [Citado 20/05/2019]; 24(1):429-35. Disponible en: https://cyberleninka.org/article/n/1041565

  6. Correia MI. Hospital malnutrition in Latin America building a culture of nutrition care: the feed M.E. Global Study Group Response to "A Quick Fix for Hospital-Acquired Malnutrition?". J Parenter Enteral Nutr. 2016; 40(4):458-9.

  7. Santana Porbén S. Estado de la desnutrición en los hospitales de Cuba: una actualización necesaria. Rev Cubana Aliment Nutr [Internet]. 2015 [Citado 23/05/2019];25(2):356-70. Disponible en: Disponible en: http://www.revalnutricion.sld.cu/index.php/rcan/article/view/139/pdf_11

  8. Ulíbarri J, González A, González P, Fernández G, Rodríguez F, Mancha A. Nuevo procedimiento para la detección precoz y control de la desnutrición hospitalaria. Nutr Hosp. 2002;17(4):179-88.

  9. Ulíbarri JI, González A, de Villar N, González P, González B, Mancha A. CONUT: A tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38-45.

  10. Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care [internet]. 2011. [Citado 20/05/2019];15(6):R268. Disponible en: Disponible en: https://www.biomedsearch.com/attachments/00/22/08/57/.../cc10546.pdf

  11. Rahman A, Hasan R, Agarwala R, Martin C, Day A, Heyland D. Identifying critically-ill patients who will benefit most from nutritional therapy: further validation of the “modified NUTRIC” nutritional risk assessment tool. Clin Nutr [Internet]. 2016 [Citado 20/05/2019];35(1):158-62. Disponible en: Disponible en: https://www.clinicalnutritionjournal.com/article/S0261-5614(15)00037-0/abstract

  12. Singer M, Deutschman C, Seymour CW, Shankar Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA [Internet]. 2016 [Citado 20/05/2019];315(8):801-10. Disponible en: Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2492881

  13. Asociación Médica Mundial. Declaración de Helsinki de la AMM. Principios éticos para las investigaciones médicas en seres humanos [Internet]. Francia: Asociación Médica Mundial; 2013 [Citado 18/02/2019]. Disponible en: Disponible en: http://www.wma.net/es/30publications/10policies/b3/index.html

  14. Moretti D, Bagilet DH, Buncuga M, Settecase CJ, Quaglino MB, Quintana R. Estudio de dos variantes de la puntuación de riesgo nutricional “NUTRIC” en pacientes críticos ventilados. Nutr Hosp [Internet]. 2014 [Citado 23/05/2019]; 29(1):166-72. Disponible en: Disponible en: http://scielo.isciii.es/pdf/nh/v29n1/22original16.pdf

  15. Mendes R, Policarpo S, Fortuna P, Alves M, Virella D, Heyland DK, et al. Nutritional risk assessment and cultural validation of the modified NUTRIC score in critically ill patients-a multicenter prospective cohort study. J Crit Care [Internet]. 2017 [Citado 20/05/2019];37:45-9. Disponible en: Disponible en: https://core.ac.uk/download/pdf/205804686.pdf

  16. de Vries MC, Koekkoek WK, Opdam MH, van Blokland D, van Zanten AR. Nutritional assessment of critically ill patients: validation of the modified NUTRIC score. Eur J Clin Nutr [Internet]. 2018 [Citado 20/05/2019];72(3):428-35. Disponible en: Disponible en: https://www.nature.com/articles/s41430-017-0008-7

  17. León Pérez DO, Molina Ricardo Y, Gutierrez Rojas AR, Larrondo Muguersia H. Evaluación del estado nutricional de pacientes críticos, en Sala de Terapia Intensiva del Hospital Hermanos Ameijeiras. Rev Cub Med Int Emerg [Internet]. 2014 [Citado 23/05/2019];13(4):374-87. Disponible en: Disponible en: http://www.revmie.sld.cu/index.php/mie/article/view/45/109

  18. Duarte MM, León D, Larrondo H, Crespo A, Segura R, Valdés L. Estado nutricional de pacientes sujetos a ventilación mecánica en una unidad de cuidados críticos. Rev Cub Aliment Nutr. 2010; 20(1):92-101.

  19. Correia MI, Perman MI, Waitzberg DL. Hospital malnutrition in Latin America: a systematic review. Clin Nutr [Internet]. 2017 [Citado 20/05/2019];36(4):958-67. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/pii/S0261561416301601

  20. Toyokawa T, Kubo N, Tamura T, Sakurai K, Amano R, Tanaka H. The pretreatment controlling nutritional status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer [internet]. 2016 [Citado 20/05/2019];16:722. Disponible en: Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/27599460

  21. Coltman A, Peterson S, Roehl K, Roosevelt H, Sowa D. Use of 3 tools to assess nutrition risk in the intensive care unit. J Parenter Enteral Nutr [Internet]. 2015 [Citado 20/05/2019];39(1):28-33. Disponible en: Disponible en: https://pdfs.semanticscholar.org/edc5/2658660b1a73183c275a0134033717482427.pdf

  22. Artmitage P, Berry G. Estadística para la Investigación Biomédica. 3 ed. Madrid: Harcourt Brace; 1997.

  23. Lew CCH, Cheung KP, Chong MFF, Chua AP, Fraser RJL, Miller M. Combining 2 commonly adopted nutrition instruments in the critical care setting is superior to administering either one alone. J Parenter Enteral Nutr [internet]. 2017 [Citado 20/05/2019];148607117726060:[Aprox. 2.] Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/28813205/

  24. Duarte MM, Crespo AM, Pérez DL, Larrondo H, Herrera ML, Pérez HA. Nutrición y función respiratoria. Acta Médica [internet]. 2003 [Citado 01/05/2019];11(1):26-37. Disponible en: Disponible en: http://www.bvs.sld.cu/revistas/act/vol11_1_03/act16103.htm

  25. Páez Y, Romero LI, Pereira OL, Gondres KM, Bacardí PA, Legró G. Factores predictivos de desnutrición en pacientes graves. Acta Colomb Cuid Intens [internet]. 2018 [Citado 01/05/2019];18(1):10-21 Disponible en: Disponible en: https://www.elsevier.es/es-revista-acta-colombiana-cuidado-intensivo-101-articulo-factores-predictivos-desnutricion-pacientes-graves-S0122726217300708

  26. Rodríguez Z. Particularidades en torno a la valoración nutricional del paciente quirúrgico. Rev Cubana Cir [Internet]. 2017 [Citado 10/03/2019]; 56(2):59-70. Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932017000200006&lng=es

  27. Benito MP, La Serna JE, Guarro M, Morera M, Camere DM, Camere MA. Estado nutricional y funcional en pacientes con enfermedad pulmonar obstructiva crónica: efectos de la suplementación nutricional oral (estudio OFOS). Nutr Hosp [Internet]. 2017 [Citado 01/05/2019].34(4):776-83. Disponible en: Disponible en: http://www.revista.nutricionhospitalaria.net/index.php/nh/article/view/748

  28. Özbilgin Ş, Hancı V, Ömür D, Özbilgin M, Tosun M, Yurtlu S, et al. Morbidity and mortality predictivity of nutritional assessment tools in the postoperative care unit. Medicine (Baltimore). [Internet] 2016 [Citado 20/05/2019];95(40):e5038. Disponible en: Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/27749567

  29. Mukhopadhyay A, Henry J, Ong V, Leong CS, Teh AL, van Dam RM, et al. Association of modified NUTRIC score with 28-day mortality in critically ill patients. Clin Nutr [Internet]. 2017 [Citado 20/05/2019];36(4):1143-8. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0261561416302011

  30. Sun X, Luo L, Zhao X, Ye P. Controlling nutritional status (CONUT) score as a predictor of all-cause mortality in elderly hypertensive patients: a prospective follow-up study. BMJ Open [Internet]. 2017 [Citado 20/05/2019]; 7(9):e015649. Disponible en: Disponible en: https://bmjopen.bmj.com/content/7/9/e015649

  31. Iseki Y, Shibutani M, Maeda K, Nagahara H, Ohtani H, Sugano K. Impact of the preoperative controlling nutritional status (CONUT) score on the survival after curative surgery for colorectal cancer. PLoSOne [Internet]. 2015 [Citado 01/05/2018];10(7):e0132488. Disponible en: Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26147805




2020     |     www.medigraphic.com