Banca de DEFESA: BRUNA LUISA GOMES DE MIRANDA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : BRUNA LUISA GOMES DE MIRANDA
DATE: 27/03/2024
TIME: 09:00
LOCAL: Sessão pública realizada por videoconferência
TITLE:

PREVALENCE OF MALNUTRITION ACCORDING TO THE GLIM CRITERIA USING DIFFERENT NUTRITIONAL RISK SCREENING TOOLS AND IT ASSOCIATION WITH MORTALITY IN PATIENTS WITH CANCER: A COMPARATIVE OBSERVATIONAL STUDY

KEY WORDS:

Neoplasms; nutritional status; malnutrition; nutritional risk.

PAGES: 48
BIG AREA: Ciências da Saúde
AREA: Nutrição
SUMMARY:

Introduction: Cancer is the second leading cause of death worldwide and leads to malnutrition in affected patients. It is known that 20% of patients die as a result of malnutrition and associated complications, and not from the disease itself. Therefore, risk assessment and nutritional status are imperative to correctly and early detect nutritional risk in these patients and encourage early intervention in those who need it. Nutritional screening and diagnosis tools become essential in this process. Objectives: To verify the prevalence of malnutrition according to the GLIM (Global Leadership on Malnutrition) criteria using different nutritional risk screening tools, and the association with mortality in cancer patients. Methods: The study represents a secondary analysis of a cohort with prospective data collection and assessment of cancer patients in a hospital setting. Nutritional risk screening was carried out using the Protocol for Nutritional Risk in Oncology (PRONTO), Nutritional Risk Screening (NRS-2002), Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST) and Nutriscore tools. The assessment of nutritional status was carried out using the criteria proposed by GLIM. Accuracy metrics were evaluated to verify the complementarity of nutritional screening with the GLIM criteria in diagnosing malnutrition, and Cox regression analysis was used to verify the association between mortality and the diagnosis of malnutrition preceded by the application of different nutritional screening tools. Results: 290 patients were evaluated, the majority of whom were elderly (60.3%), female (53.1%) and with solid tumors (89.7%). Of the total, 118 (40.7%) individuals died. The PRONTO tool identified more individuals (n = 240, 82.8%) at risk of malnutrition, compared to the others. However, like the others, it presented reduced complementarity to the GLIM criteria, taking into account specificity values (44.6%) and negative predictive value (58.0%) obtained. Regarding the risk of mortality, after adjustment for confounding variables, the presence of malnutrition according to GLIM, without prior screening, was associated with mortality (HR: 3.35; 95% CI 1.70 – 6.80; p < 0.001). Nutritional risk was also an independent predictor of death, regardless of the nutritional screening tool used (HR between 1.70 and 10.07). Furthermore, the presence of nutritional risk and malnutrition, regardless of the screening tool used, increased the risk of death between 1.93 and 4.43 times. Patients with nutritional risk identified by the ASG-PPP tool and malnutrition by GLIM had a higher risk of death compared to those with malnutrition and nutritional risk identified by the other tools (HR: 4.43; 95%CI 2.33 – 8.42; p < 0.001). Conclusion: The prevalence of malnutrition according to GLIM depends on the tool applied to screen nutritional risk prior to assessing the presence of etiological and phenotypic criteria, and was higher when applied to ASG-PPP. Despite this, the findings suggest that none of these adequately complemented GLIM, or appropriately identified nutritional risk through the factors they use. Nutritional risk and malnutrition alone or in combination, regardless of the nutritional screening tool applied, were predictors of death in cancer patients.

COMMITTEE MEMBERS:
Presidente - 1879430 - ANA PAULA TRUSSARDI FAYH
Externa à Instituição - MARIA CRISTINA GONZALEZ - UFPel
Interna - 1452705 - SEVERINA CARLA VIEIRA CUNHA LIMA