Desfechos clínicos de idosos submetidos à cirurgia cardíaca em um hospital universitário do Distrito Federal e sua relação com o estado nutricional

Abstract

Introduction: population aging is a worldwide event, which leads to numerous systemic changes, with repercussions on the nutritional status and general health of the elderly. Objectives: to correlate clinical outcomes with nutritional status determined by subjective and objective methods in elderly patients submitted to cardiac surgery in a referral hospital in the Federal District (DF); to verify the frequency of nutritional risk in the elderly patients through the subjective methods; to identify the frequency of malnutrition in elderly patients by means of objective nutritional status assessment methods; to verify the agreement between the subjective methods of evaluation of nutritional status. Methods: this is a prospective cohort study carried out at the Inpatient Unit of a referral hospital in the Federal District, Brazil, for the treatment of patients from the Unified Health System - from February to July 2018. Patients were evaluated in the preoperative and postoperative phase with subjective methods and objective methods. Results: the final sample consisted of 84 (94.38%) patients. In relation to the anthropometric variables, a significant reduction in weight (p = 0.001), arm circumference (p = 0.001) and palmar grip strength (p = 0.001) were observed in the postoperative period when compared to preoperative cardiac surgery. There was no association of the final outcome (discharge or death) with the nutritional risk determined by the NRS-2002 method (p = 0.30). However, patients who died had a longer time of cardiopulmonary bypass (p = 0.02). Products developed: the review articles titled: "Subjective and objective methods for assessing nutritional status of elderly patients with heart failure"; "Subjective methods of evaluation of nutritional status in elderly patients with heart disease: a review of the literature"; "Evidence of the efficacy of phytotherapy for the treatment of depression in the elderly compared to allopathic drug therapy by scoping review". The original article titled: "Clinical Outcomes of Older Patients Undergoing Cardiac Surgery at a University Hospital of the Federal District and its Relation to Nutritional Status." The clinical protocol entitled: "Suggestion of clinical protocol for elderly patients with heart disease assisted by the single health system". The case report entitled: "Nutritional status of an elderly patient with acute myocardial infarction hospitalized for coronary artery bypass grafting in the pre and postoperative period". The chapters of the books entitled: "Application of sarcopenia screening questionnaire (SARC-F + CC) in an elderly patient with heart failure"; "Clinical, nutritional and sarcopenic evaluation of an elderly patient with assisted heart failure in a public reference hospital in the Federal District"; "Screening for sarcopenia (SARC-F) and palmar grip strength (FPP) in an elderly patient with congestive heart failure"; "Analysis of the risk of sarcopenia (SARC-F) and palmar grip strength (FPP) in an elderly woman with heart failure treated at a referral hospital in the Federal District". Publication of summary entitled: "Subjective methods of evaluation of nutritional status in elderly patients with heart disease". The book of recipes (Ebook) entitled: "Cookbook for elderly heart disease: healthy and cardioprotective food". Conclusions: the results indicate a lack of correlation between clinical outcomes and nutritional status determined by subjective and objective methods in elderly patients submitted to cardiac surgery. The high CPB time had a negative impact on the final outcome of the elderly patients. The performance of a cardiac surgical procedure in the elderly increases the nutritional risk and malnutrition.