Banca de QUALIFICAÇÃO: DANNA CALINA NOGUEIRA E SILVA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : DANNA CALINA NOGUEIRA E SILVA
DATE: 29/11/2024
TIME: 14:00
LOCAL: Sessão pública realizada por videoconferência
TITLE:

COMPETITIVE AND PREDICTIVE VALIDATION OF THE NUTRITIONAL RISK ASSESSMENT INSTRUMENT PROtocol for NuTritional risk in Oncology (PRONTO)

KEY WORDS:

Neoplasms; nutritional risk; nutritional assessment; weight loss; length of stay, mortality

PAGES: 52
BIG AREA: Ciências da Saúde
AREA: Nutrição
SUMMARY:

Introduction: Cancer is a complex disease characterized by the irregular growth of malignant cells and is the second leading cause of death worldwide. It causes metabolic changes, often resulting in nutritional deficits, such as malnutrition. Approximately 20% of cancer patients die from malnutrition and associated complications, not from the disease itself. Therefore, early diagnosis of nutritional risk contributes to monitoring the disease and reduces the risk of negative adverse events. Objective: To evaluate the concurrent and predictive validity of the PROtocol for Nutritional Risk in Oncology (PRONTO) for diagnosing nutritional risk in cancer patients. Methods: The study is a secondary analysis of a cohort with prospective data collection, which evaluated cancer patients in a hospital environment at the Onofre Lopes University Hospital - HUOL, of both sexes, aged over 20 years. Sociodemographic and anthropometric data were collected (BMI, calf circumference, hand grip strength). Nutritional risk was assessed using the reduced version of the Subjective Global Assessment Produced by the Patient (ASG-PPP) and the Protocol for Nutritional Risk in Oncology (PRONTO). Patients were evaluated up to 6 months after hospital discharge to assess the outcome of interest (length of hospital stay, hospital death, readmission and mortality after discharge). To verify the concurrent validity of PRONTO for diagnosing nutritional risk, accuracy metrics were calculated and Cox regression analysis was conducted to verify the association between the outcomes of interest and the presence of nutritional risk. Results: A total of 390 patients were evaluated, the majority of whom were elderly (45.6%), female (53.6%), had solid tumors (89%) and advanced stages of the disease (42.3%). Approximately half of the sample underwent chemotherapy treatment only (39.5%). The frequency of nutritional risk was higher for PRONTO when compared to ASG-PPP (84.4% vs 76.4%, respectively). The PRONTO nutritional risk classification showed moderate accuracy in identifying patients at nutritional risk (AUC 0.76, 95% CI 0.68 - 0.79), taking into account the sensitivity (95.3%) and positive predictive value (86.3%) obtained. There was a significantly higher incidence of non-elective readmission at six months (34.8% vs 11.4%, P = 0.001) and mortality at six months (39.9% vs 6.8%, P < 0.001) in those patients at nutritional risk by PRONTO. It was a predictor of a higher risk of mortality at six months (adjusted HR 2.96, 95% CI 1.05-8.32, p=0.040). Conclusion: The PRONTO tool is satisfactorily accurate, showing good detection of nutritional risk, although it has a limitation in correctly excluding individuals who do not have the condition. The nutritional risk assessed by PRONTO was shown to be a potential predictor of six-month mortality in cancer patients.

COMMITTEE MEMBERS:
Presidente - 1879430 - ANA PAULA TRUSSARDI FAYH
Externa à Instituição - FLÁVIA MORAES SILVA - UFC
Externa à Instituição - Gabriela Villaça Chaves - INCA