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Exploração da utilização de percentis da força preensora da mão de idosos portugueses: uso e validade para o rastreio da desnutrição em idosos hospitalizados
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| TC_29762 | 1 MB | Adobe PDF |
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Objetivo: Estudar a adequação e a validade da força preensora da mão (FPM) como método de rastreio da desnutrição na admissão hospitalar de pessoas idosas.
Metodologia: Realizou-se um estudo transversal num hospital universitário numa amostra de idosos (idade ≥65 anos). Recolheram-se dados sociodemográficos, clínicos e nutricionais. Identificou-se a presença da desnutrição com o Nutritional Risk Screening 2002 (NRS-2002) e a presença e grau de desnutrição com o Scored Patient-Generated Subjective Global Assessment (PG-SGA). Mediu-se a FPM com um dinamómetro.
Calcularam-se as sensibilidades e as especificidades da FPM para o rastreio da desnutrição com recurso às ferramentas PG-SGA e NRS-2002 utilizadas como métodos diagnósticos. Estes cálculos foram realizados com a amostra estratificada para o sexo e utilizaram-se valores da FPM da população idosa portuguesa, tendo sido considerados os percentis 15, 25 e 50 da FPM, estratificados por sexo, classe etária e estatura.
Resultados: A amostra deste estudo é composta por 233 participantes (40.3% mulheres), com idades entre 65-91 anos. De acordo com o PG-SGA 46,8% dos homens e 37,2% das mulheres apresentavam desnutrição na forma moderada/suspeita ou grave e que 40,3% dos homens e 68,1% das mulheres apresentavam desnutrição de acordo com o NRS-2002. Recorrendo ao NRS-2002 como método de identificação da desnutrição, as sensibilidades da FPM variaram entre 37,0% e 89,1% e as especificidades variaram entre 21,4% e 77,0%. Os valores mais elevados de sensibilidade para ambos os sexos foram obtidos utilizando o P50 da FPM, enquanto que para a especificidade, o maior valor foi obtido para o P25 no caso das mulheres e para o P15 no caso dos homens.
Recorrendo ao PG-SGA para a identificação da desnutrição, as sensibilidades variaram entre 37,3% e 89,6% e as especificidades variaram entre 20,0% e 80,0%. Para ambos os sexos, os melhores valores de sensibilidade foram obtidos utilizando o P50 da FPM, e para a especificidade utilizando o P15 de FPM.
Conclusão: A FPM é um método promissor no rastreio da desnutrição na admissão hospitalar de idosos portugueses, devido aos bons valores de sensibilidade obtidos.
Devido aos baixos valores de especificidade obtidos não é possível recomendar a FPM como método para rastreio da desnutrição em idosos hospitalizados.
Aim: To study the adequacy and validity of hand grip strength (HGS) for undernutrition screening of older adults at hospital admission. Methodology: A cross-sectional study was carried out in a university hospital in a sample of older adults (age ≥65 years). Sociodemographic, clinical and nutritional data were collected. The presence of undernutrition was identified with the Nutritional Risk Screening 2002 (NRS-2002) and the presence and severity of undertrition with the Scored Patient-Generated Subjective Global Assessment (PG-SGA). HGS was measured with a dynamometer. The sensitivities and specificities of the HGS for undernutrition screening were calculated using PG-SGA and NRS-2002 tools as diagnostic methods. These calculations were carried out with the sample stratified for sex and the HGS values of the Portuguese older adults were used, considering the 15th, 25th and 50th percentiles of HGS stratified by sex, age and height. Results: This study' sample is composed of 233 participants (40.3% women), aged 65-91 years. According to PG-SGA, 46.8% of men and 37.2% of women presented moderate / suspected or severe undertrition and 40.3% of men and 68.1% of women presented undernutrition according to the NRS-2002. Using NRS-2002 as the diagnostic method, the sensitivities of HGS varied between 37.0% and 89.1% and the specificities varied between 21.4% and 77.0%. The highest values of sensitivity for both sexes were obtained using the P50 of HGS, whereas for specificity, the highest value was obtained for the P25 in the case of women and for the P15 in the case of men. Using PG-SGA, sensitivities varied between 37.3% and 89.6% and specificities varied between 20.0% and 80.0%. For both sexes, the best sensitivity values were obtained using the P50 of HGS, and for specificity using the P15. Conclusion: HGS is a promising method for undernutrition screening of Portuguese older adults at the hospital admission, due to the good sensitivity values obtained. Due to the low specificity values obtained, it is not possible to recommend HGS as a method for undernutrition screening in hospitalized older adults.
Aim: To study the adequacy and validity of hand grip strength (HGS) for undernutrition screening of older adults at hospital admission. Methodology: A cross-sectional study was carried out in a university hospital in a sample of older adults (age ≥65 years). Sociodemographic, clinical and nutritional data were collected. The presence of undernutrition was identified with the Nutritional Risk Screening 2002 (NRS-2002) and the presence and severity of undertrition with the Scored Patient-Generated Subjective Global Assessment (PG-SGA). HGS was measured with a dynamometer. The sensitivities and specificities of the HGS for undernutrition screening were calculated using PG-SGA and NRS-2002 tools as diagnostic methods. These calculations were carried out with the sample stratified for sex and the HGS values of the Portuguese older adults were used, considering the 15th, 25th and 50th percentiles of HGS stratified by sex, age and height. Results: This study' sample is composed of 233 participants (40.3% women), aged 65-91 years. According to PG-SGA, 46.8% of men and 37.2% of women presented moderate / suspected or severe undertrition and 40.3% of men and 68.1% of women presented undernutrition according to the NRS-2002. Using NRS-2002 as the diagnostic method, the sensitivities of HGS varied between 37.0% and 89.1% and the specificities varied between 21.4% and 77.0%. The highest values of sensitivity for both sexes were obtained using the P50 of HGS, whereas for specificity, the highest value was obtained for the P25 in the case of women and for the P15 in the case of men. Using PG-SGA, sensitivities varied between 37.3% and 89.6% and specificities varied between 20.0% and 80.0%. For both sexes, the best sensitivity values were obtained using the P50 of HGS, and for specificity using the P15. Conclusion: HGS is a promising method for undernutrition screening of Portuguese older adults at the hospital admission, due to the good sensitivity values obtained. Due to the low specificity values obtained, it is not possible to recommend HGS as a method for undernutrition screening in hospitalized older adults.
Descrição
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciado em Ciências da Nutrição
Palavras-chave
Força preensora da mão Desnutrição hospitalar Idosos NRS-2002 PG-SGA Sensibilidade Especificidade Handgrip strength Hospital undernutrition Older adults NRS-2002 PG-SGA Sensitivity Specificity