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Validade do MNA-full form e do MNA-short form em prever indicadores de resultado clínico e o benefício da intervenção nutricional
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Abstract(s)
Objetivos Avaliar a validade concorrente e preditiva do MNA-Full e do MNA-SF: estudar a concordância entre as ferramentas, quantificar a associação entre desnutrição ou risco identificados pelas ferramentas com o tempo de internamento, com co-morbilidades e com o benefício da intervenção nutricional. Metodologia Incluíram-se doentes com ≥65 anos internados numa Unidade de Cuidados Continuados entre Janeiro/2017-Junho/2019. Recolheu-se sexo, idade, destino de alta, diagnósticos, terapia nutricional e pontuações obtidas no MNA-SF e MNA-Full na admissão e na alta. Calculou-se o valor de kappa. Estudou-se a associação entre o MNA-Full e o MNA-SF com o tempo de internamento com modelos de regressão de Cox e a associação das duas ferramentas com o índice de Charlson com modelos de regressão logística binária. Avaliou-se a associação entre a evolução do estado nutricional com a terapêutica nutricional instituída. Resultados A amostra do presente estudo incluiu 80 participantes (57 mulheres), com idades entre 66-95 anos. O valor de kappa entre o MNA-SF e o MNA Full-Form foi 0,702 (p<0,001). Risco de desnutrição (HR=0,101; IC95%: 0,026-0,389) e desnutrição (HR=0,177; IC95%: 0,050-0,619) pelo MNA-Full associam-se a menor probabilidade de alta para residência habitual. Tal associação não se verificou para o MNA-SF. Não se encontraram associações entre MNA-Full e MNA-SF com o índice de Charlson. A terapêutica nutricional instituída não se associou com a evolução do estado nutricional avaliado com ambas as ferramentas. Conclusões Demonstrou-se elevada concordância entre o MNA-Full e o MNA-SF. Verificou-se associação entre o MNA-Full e o tempo de internamento. Os resultados não permitem excluir a necessidade da aplicação do MNA-Full na avaliação do estado nutricional dos idosos.
Objective To evaluate the concurrent and predictive validity of MNA-Full and MNA-SF: to study the agreement between the tools, to quantify the association between undernutrition or risk identified by the tools with length of hospital stay, comorbidities and the benefit of nutritional intervention. Methodology Patients aged ≥65 years admitted to long-term care facilities between January/2017-June /2019 were included in the study. Gender, age, discharge destination, diagnosis, nutritional therapy, and MNA-SF and MNA-Full scores at admission at discharge were collected. The kappa value was calculated. The studied between MNA-Full and MNA-SF with time of hospital stay was studied using Cox regression models and the association of the two tools with the Charlson was assessed with binary logistic regression models. The association between the evolution of nutritional status and the nutritional therapy given was evaluated. Results The present study´s sample included 80 participants (57 women), aged between 66-95 years. The kappa value between MNA-SF and Full-Form MNA was 0.702 (p <0.001). Risk of undernutrition (HR = 0.101; 95% CI: 0.026-0.389) and undernutrition (HR = 0.177; 95% CI: 0.050 0.619) by MNA-Full were associated with a lower probability of discharge to usual residence. Such association was not verified for MNA-SF. No associations were found between MNA-Full and MNA-SF with the Charlson Index. The nutritional therapy given was not associated with the evolution of the nutritional status evaluated with both tools. Conclusions A good agreement between MNA-Full and MNA-SF was found. An association between MNA-Full and length of hospital stay was also found. The results do not allow to exclude the need for application of the MNA-Full in the evaluation of the nutritional status of older adults.
Objective To evaluate the concurrent and predictive validity of MNA-Full and MNA-SF: to study the agreement between the tools, to quantify the association between undernutrition or risk identified by the tools with length of hospital stay, comorbidities and the benefit of nutritional intervention. Methodology Patients aged ≥65 years admitted to long-term care facilities between January/2017-June /2019 were included in the study. Gender, age, discharge destination, diagnosis, nutritional therapy, and MNA-SF and MNA-Full scores at admission at discharge were collected. The kappa value was calculated. The studied between MNA-Full and MNA-SF with time of hospital stay was studied using Cox regression models and the association of the two tools with the Charlson was assessed with binary logistic regression models. The association between the evolution of nutritional status and the nutritional therapy given was evaluated. Results The present study´s sample included 80 participants (57 women), aged between 66-95 years. The kappa value between MNA-SF and Full-Form MNA was 0.702 (p <0.001). Risk of undernutrition (HR = 0.101; 95% CI: 0.026-0.389) and undernutrition (HR = 0.177; 95% CI: 0.050 0.619) by MNA-Full were associated with a lower probability of discharge to usual residence. Such association was not verified for MNA-SF. No associations were found between MNA-Full and MNA-SF with the Charlson Index. The nutritional therapy given was not associated with the evolution of the nutritional status evaluated with both tools. Conclusions A good agreement between MNA-Full and MNA-SF was found. An association between MNA-Full and length of hospital stay was also found. The results do not allow to exclude the need for application of the MNA-Full in the evaluation of the nutritional status of older adults.
Description
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Ciências da Nutrição
Keywords
Idosos Desnutrição Tempo de internamento Comorbilidades Terapêutica nutricional Older adults Undernutrition Hospital length Comorbidities Nutritional therapy