RESUMO
AIM: This study evaluated the association between risk of malnutrition and performance status, and mortality in hospitalized breast cancer patients. METHODS: Prospective cohort study with hospitalized breast cancer patients evaluated at a referral Cancer Center. The Risk of malnutrition was assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and performance status was determined using the Eastern Cooperative Oncology Group Performance Status Scale (ECOG PS). Logistic regression was used to analyze the factors associated with death, using the odds ratio (OR) with a 95% confidence interval (CI) as an effect measure. RESULTS: A total of 195 woman were included, with a mean age of 56.3 (±12.6) years. Patients with an overall PG-SGA score ≥18 (OR: 2.11; 95% CI: 1.03-4.62) and ECOG PS ≥ 3 (OR: 3.34; 95% CI: 1.48-7.52) had a higher occurrence of death during hospitalization, regardless of age or disease stage. The concomitant presence of these two factors improved the accuracy of the association (OR: 5.32; 95% CI: 3.11-9.76) and showed good predictive accuracy (C-statistics: 0.77). CONCLUSION: Nutritional risk and poor performance status were associated with a higher occurrence of death in women with breast cancer. The use of these two indicators improves their predictive accuracy for mortality.
Assuntos
Neoplasias da Mama , Desnutrição , Humanos , Feminino , Pessoa de Meia-Idade , Estado Nutricional , Avaliação Nutricional , Estudos Prospectivos , Desnutrição/diagnóstico , Desnutrição/epidemiologiaRESUMO
BACKGROUND & AIMS: To evaluate the impact of energy deficit during hospitalization and the biomarkers albumin and C-reactive protein (CRP) on the clinical outcomes length of stay (LOS) and duration of mechanical ventilation (DMV) in children and adolescents admitted to the pediatric intensive care unit (PICU) of a private hospital in Rio de Janeiro. METHODS: A longitudinal, retrospective study was conducted of the medical records of patients admitted to the PICU from May 2016 to June 2017 who received enteral nutrition (EN) for 72 h or longer. The cut-off points for serum albumin and CRP were set at ≥3.5 and <2.0, respectively. The energy balance was calculated as the difference between the energy prescribed and the energy received by the patient. The comparison of continuous variables related to LOS and DMV was assessed using Student's t-test and the Mann-Whitney test. The significance value was set at p < 0.05. RESULTS: Ninety-three patients were selected, with a median age of 32 (±39.49) months. The mean serum albumin and CRP levels were 4.04 (±0.59) and 4.67 (±7.40), respectively. In linear regression models adjusted for length of stay, reduced albumin, increased CRP, and negative energy balance were positively associated. In the models adjusted to DMV, the values for reduced albumin and increased CRP were significant. CONCLUSION: A significant association was found between serum albumin and CRP at admission and the outcomes under investigation, LOS and DMV. Energy deficit was also associated with LOS.