Acurácia do Global Leadership Initiative on Malnutrition para identificar a desnutrição em pacientes hospitalizados
Palavras-chave:
Idosos, Antropometria, Acurácia dos dados, Hospitalização, Avaliação nutricionalResumo
Objetivo
O Global Leadership Initiative on Malnutrition, apresentado como um método útil no diagnóstico de desnutrição, possui poucas evidências acerca de indivíduos hospitalizados. Portanto, exploramos esse método com dois objetivos: 1) comparar a acurácia diagnóstica dos critérios Global Leadership Initiative on Malnutrition com a Avaliação Subjetiva Global Produzida pelo Paciente; 2) determinar a prevalência de desnutrição e seus fatores associados.
Métodos
Estudo transversal, realizado com indivíduos hospitalizados entre abril de 2019 a julho de 2021. Informações sociodemográficas, clínicas e antropométricas foram investigadas. Global Leadership Initiative on Malnutrition foi o index test e Avaliação Subjetiva Global Produzida pelo Paciente a referência padrão para avaliar desnutrição. Para acurácia diagnóstica considerou-se as medições de sensibilidade, especificidade e área sob a curva e concordância kappa.
Resultados
Participaram 105 indivíduos (65,9±9,9 anos). A prevalência de desnutrição na amostra total foi de 48,6% e 67,6% de acordo com os critérios Global Leadership Initiative on Malnutrition e Avaliação Subjetiva Global Produzida pelo Paciente, respectivamente. Associações foram encontradas entre desnutrição e as variáveis motivo de internação, estresse metabólico e indicadores antropométricos (p<0,05). A comparação mostrou valores de sensibilidade e especificidade para os critérios Global Leadership Initiative on Malnutrition de 67,6% (IC 95%: 56,1-77,3) e 91,2% (IC 95%: 77,0- 96,9) (amostra total) e 71,7% (IC 95%: 58,4-82,0) e 95,5% (IC 95%: 78,2-99,2) (idosos), respectivamente. Observou-se concordância de 49,0%, sendo 55,0% quando os idosos foram analisados separadamente.
Conclusão
Os critérios Global Leadership Initiative on Malnutrition apresentaram condições adequadas de sensibilidade e especificidade para diagnosticar desnutrição, concordância moderada com o padrão de referência e boa aplicabilidade na prática clínica em hospitalizados. A prevalência de desnutrição foi elevada, independentemente do método utilizado, e apresentou relação com o motivo de internação, estresse metabólico e indicadores antropométricos.
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Copyright (c) 2023 Francielly Gonçalves de SOUZA, Flávia Andréia MARIN, Wanderson Roberto da SILVA, Maria Claudia Bernardes SPEXOTO
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
