Estado nutricional e evolução clínica de idosos em terapia nutricional enteral domiciliar: um estudo de coorte retrospectivo

Abstract

Introduction: the prevalence of the elderly with home enteral nutritional therapy (HENT) has grown worldwide. The elderly in HENT may already enter home care in the presence of risk of malnutrition or malnutrition but may also become malnourished during home care. To evaluate the clinical and nutritional evolution of the elderly receiving HENT, it is essential to emphasize the importance of the subsidy of HENT programs by the SUS that can provide a better quality of life due to therapeutic humanization. Objective: to evaluate the clinical and nutritional evolution of elderly patients receiving home enteral nutritional therapy. Method: an observational cohort study of a retrospective design whose data collection was done through clinical and nutritional records medical records analysis. Demographic, nutritional and clinical variables were analyzed. Sample consisting of elderly patients, using HENT. The statistical analysis of the data was performed by the IBM Statistical Package for the Social Sciences. The descriptive statistics were presented by mean, standard deviation and frequencies. The Kolmogorov Smirnov test showed normal distribution of the data and thus the ANOVA test was performed for the descriptive analyzes and the comparison tests. The correlation between the variables was verified by POST HOC Tukey. Adopting the level of statistical significance of p-value <0.05 and Confidence Interval of 95%. Results: sample of 218 participants with a mean age of 76 ± 10.12 years, being 54.1% female. The main disease was sequelae due to stroke, (31.2%, n = 68). Malnutrition was the main nutritional diagnosis (65.1%, n = 142) and the Global Subjective Assessment was the main nutritional assessment instrument (34.3%, n = 47). The route of administration of the most prevalent diet was nasoenteric / nasogastric (62.4%, n = 136); however, after one year of follow-up, gastrostomy became the main route of administration (36.2%; n = 79). There was a predominance of general condition (50.9%, n = 55) and the most prevalent clinical outcome was death (39%, n = 62). Conclusions: HENT can contribute to a better clinical and nutritional evolution of the assisted elderly, as it is associated with lower numbers of rehospitalizations, maintenance of nutritional status and maintenance of the general condition of the patient. Products: this dissertation is composed of three products, an original article titled "Nutritional status and clinical evolution of the elderly in home enteral nutritional therapy: a retrospective cohort" was submitted for publication by the Latin American Journal of Nursing, Qualis / CAPES Nursing A1; a manual of guidelines on enteral nutritional therapy for patients, caregivers and family entitled: "Manual of guidelines on Home Enteral Therapy" published as book in first edition, ISBN 978-85-913928-9-6; and a case report entitled "Comprehensive Geriatric Assessment in Hospitalized Seniors after Videoolaparoscopic Cholecystectomy" which was published in the first edition of the book Multidimensional Evaluation of the Elderly, ISBN 978-85-94473-03-5.