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Introduction: Nutrition Impact Symptoms (NIS) are common in hospitalized patients and can be aggravated in the presence of malnutrition. Objective: To verify the presence of NIS and its association with sociodemographic and clinical variables, sarcopenia phenotype, and nutritional status of individuals hospitalized. Methods: This is a cross-sectional study with hospitalized patients, of both sexes and ≥50 years old. Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength (HGS), gait speed GS), and anthropometric measurements were performed up to 48 hours after admission. NIS was obtained through PG-SGA and stratified into two groups: <3 and ≥3 symptoms. The chi-square test (χ2) was performed, and a 5% significance level was adopted. Results: A total of 90 patients (65.4±9.67 years) were studied, with the majority of men (56.7%), older people (70.0%), married (68.9%), low economic class (72.2%), without work activity (70.5%), with two previous diseases (60.0%), overweight by body mass index (46.7%) and adequate adductor pollicis muscle thickness (83.3%). The most prevalent NIS were "dry mouth", “anorexia”, and "smells sick" respectively 31.1%, 30.0%, and 16.7%. There was an association between NIS and SARC-F score (p=0.002), handgrip strength (p=0.016), the status of sarcopenia (p=0.020), PG-SGA (p<0.001), and economic status (p=0.020). Conclusion: The identification of NIS is common, and may infer negative nutritional status and functional performance of patients. The use of protocols to identify NIS during hospitalization should be considered to minimize the negative impact on nutritional status.
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Duarte A, Marques AR, Sallet LHB, Colpo E. Risco nutricional em pacientes hospitalizados durante o período de internação. Nutr Clín Diet Hosp. 2016;36(3):146-52. http://dx.doi.org/10.12873/363duarte
Gomes F, Schuetz P, Bounoure L, Austin P, Ballesteros-Pomar M, Cederholm T, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients. Clin Nutr. 2018;37(1):336-53. http://dx.doi.org/10.1016/j.clnu.2017.06.025
Castro MG, Ribeiro PC, Souza IDO, Cunha HFR, Silva MHN, Rocha EEM, et al. Diretrizes Brasileira de Terapia Nutricional no paciente grave. BRASPEN J. 2018;33(Supl 1):2-36.
Correia MITD, Perman MI, Waitzberg DL. Hospital malnutrition in Latin America: a systematic review. Clin Nutr. 2017;36:958-67. https://doi.org/10.1016/j.clnu.2016.06.025
Bianchi L, Abete P, Bellelli G, Bo M, Cherubini A, Corica F, et al. Prevalence and clinical correlates of sarcopenia, identified according to the EWGSOP definition and diagnostic algorithm, in Hospitalized Older People: The GLISTEN Study. J Gerontol. A Biol. Sci. Med. Sci. 2017;72(11):1575-81. https://doi.org/10.1093/gerona/glw343
Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM, Biolo G, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: Joint document elaborated by Special Interest Groups (SIG) “ cachexia-anorexia in chronic wasting diseases” and “ nutrition in geriatrics.” Clin Nutr. 2010;29(2):154-9. https://doi.org/10.1016/j.clnu.2009.12.004
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169
Yeung SSY, Reijnierse EM, Pham VK, Trappenburg MC, Lim WK, Meskers CGM, et al. Sarcopenia and its association with falls and fractures in older adults: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2019;10(3):485-500. https://doi.org/10.1002/jcsm.12411
Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One. 2017;12 (1):e0169548. https://doi.org/10.1371/journal.pone.0169548
Trifiletti AA, Misino P, Giannantoni P, Giannantoni B, Cascino A, Fazi L, et al. Comparison of the performance of four different tools in diagnosing disease-associated anorexia and their relationship with nutritional, functional and clinical outcome measures in hospitalized patients. Clin Nutr. 2013;32(4):527-32. https://doi.org/10.1016/j.clnu.2012.11.011
Lindqvist C, Slinde F, Majeed A, Bottai M, Wahlin S. Nutrition impact symptoms are related to malnutrition and quality of life – A cross-sectional study of patients with chronic liver disease. Clin Nutr. 2020;39(6):1840-8. https://doi.org/10.1016/j.clnu.2019.07.024
Gonzalez MC, Borges LR, Silveira DH, Assunção MCF, Orlandi SP. Validação da versão em português da avaliação subjetiva global produzida pelo paciente. Rev Bras Nutr Clin. 2010;25(2):102-8.
Nordén J, Grönberg AM, Bosaeus I, Forslund HB, Hulthén L, Rothenberg E, et al. Nutrition impact symptoms and body composition in patients with COPD. Eur J Clin Nutr. 2014;69(2):256-61. https://doi.org/10.1038/ejcn.2014.76
Rus GE, Porter J, Brunton A, Crocker M, Kotsimbos Z, Percic J, et al. Nutrition interventions implemented in hospital to lower risk of sarcopenia in older adults: A systematic review of randomised controlled trials. Nutr Diet. 2020;77(1):90-102. https://doi.org/10.1111/1747-0080.12608
Associação Brasileira de Empresas de Pesquisa (ABEP). Critério de Classificação Econômica Brasil. Available from: http://www.abep.org/criterioBr/01_cceb_2019.pdf
World Health Organization (WHO). Physical status: the use and interpretation of anthropometry. Geneva: World Health Organization, 1995.
Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55-67.
Lameu EB, Gerude MF, Corrêa RC, Lima KA. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clin. 2004;59(2):57-62. https://doi.org/10.1590/S0041-87812004000200002
Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JE. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28-36. https://doi.org/10.1002/jcsm.12048
Dodds RM, Syddall HE, Cooper R, Benzeval M, Deary IJ, Dennison EM, et al. Grip strength across the life course: Normative data from twelve British studies. PLoS One. 2014;9(12):e113637. https://doi.org/10.1371/journal.pone.0113637
Fess EE. Grip strength. In: Casanova JS. Clinical Assessment Recommendations. 2nd ed. Chicago: American Society of Hand Therapists, 1992:41-5.
Barbosa-Silva TG, Menezes AMB, Bielemann RM, Malmstrom TK, Gonzalez MC. Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc. 2016;17(12):1136-41. http://dx.doi.org/10.1016/j.jamda.2016.08.004
Lohman TG, Roche AF, Martorell R. Antthropometric standardization reference manual. Human Kinetics Books, 1988.
Jager-Wittenaar H, Ottery FD. Assessing nutritional status in cancer: Role of the Patient-Generated Subjective Global Assessment. Curr Opin Clin Nutr Metab Care. 2017;20(5):322-9. https://doi.org/10.1097/MCO.0000000000000389
Molina-Molina E, Garruti G, Shanmugam H, Di Palo DM, Grattagliano I, Mastronuzzi T, et al. Aging and nutrition. Paving the way to better health. Rom J Intern Med. 2020;58(2):55-68. http://doi.org/10.2478/rjim-2020-0005
Mastronuzzi T, Grattagliano I. Nutrition as a health determinant in elderly patients. Curr Med Chem. 2019;26(19):3652-61. http://doi.org/10.2174/0929867324666170523125806
Silva TL, Pretto ADB, Gonzalez MC, Pastore CA. Association between nutritional subjective global assessment and manual dynamometry in cancer patients of a chemotherapy service in Southern Brazil. Rev Bras Oncol Clin. 2015;11(40):66-70.
Bohannon RW. Grip strength : an indispensable biomarker for older adults. Clin Interv Aging. 2019;14:1681-91. https://doi.org/10.2147/CIA.S194543
Bonganha V, Santos CF, Rocha J, Chacon-Mikahil MPT, Madruga VA. Força muscular e composição corporal de mulheres na pós-menopausa: efeitos do treinamento concorrente. Rev Bras Ativ Fís Saúde. 2008;13(2):102-9. https://doi.org/10.12820/rbafs.v.13n2p102-109
Fragas RFM, Oliveira MC. Risk factors associated with malnutrition in hospitalized patients. Rev Nutr. 2016;29(3):329-36. https://doi.org/10.1590/1678-98652016000300003
Knudsen AW, Naver A, Bisgaard K, Nordgaard-Lassen I, Becker U, Krag A, et al. Nutrition impact symptoms, handgrip strength and nutritional risk in hospitalized patients with gastroenterological and liver diseases. Scand J Gastroenterol. 2015;50(10):1191-8. https://doi.org/10.3109/00365521.2015.1028994
Rolland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, et al. Sarcopenia, calf circumference, and physical function of elderly women: A cross-sectional study. J Am Geriatr Soc. 2003;51(8):1120-4. https://doi.org/10.1046/j.1532-5415.2003.51362.x
Wijnhoven HAH, van der Schueren MAEB, Heymans MW, Vet HCW, Kruizenga HM, Twisk JW, et al. Low mid-upper arm circumference, calf circumference, and body mass index and mortality in older persons. J Gerontol A Biol Sci Med Sci. 2010;65(10):1107-14. https://doi.org/10.1093/gerona/glq100
Bachettini NP, Bielemann RM, Barbosa-Silva TG, Menezes AMB, Tomasi E, Gonzalez MC. Sarcopenia as a mortality predictor in community-dwelling older adults: a comparison of the diagnostic criteria of the European Working Group on Sarcopenia in Older People. Eur J Clin Nutr. 2020;74(4):573-80. https://doi.org/10.1038/s41430-019-0508-8