Analysis of nutritional assistance to dysphagic patients hospitalized from a quality perspective
DOI: 10.15343/0104-7809.200933.3.7
Keywords:
Deglutition Disorders. Nutrition Assessment. Nutrition Therapy.Abstract
Dysphagia is a highly debilitating clinical condition that can result in serious complications as aspiratory pneumonia, dehydration and malnutrition. This
study had as its aim to improve the quality of nutritional assistance to dysphagic patients in HU-USP, with approval by the Committee of Ethics in Research (CEP
58/08). For doing this, we established the nutritional profile by means of anthropometric (analysis from standards of reference according to age and gender) and
biochemical evaluation, and we also considered phase angle evaluated by electric bioimpedance. On the other hand, the standard of diets of HU-USP was analyzed
as regards nutritional composition by using the computer program Nutwin®. From August to December 2008 30 dysphagic patients were monitored; 50% were acute
cases and 50% chronic. As the main causes of oropharyngeal dysphagia, most cases were due to diseases of neurogenic origin (90% of the cases), with a practically
homogeneous distribution as concerns gender (53,3% men and 46.7% women) and predominance of aged patients (86,7%). It was verified the existence of nutritional
compromising for most subjects of the sample. Phase angle was > 4° in 63,3% of patients, indicating favorable prognostic and conditions for rehabilitation, and we
observed a significant statistical difference among averages of the group that was discharged from the hospital and the one whose patients has died in the period.
Moreover, a significant correlation was observed between phase angle and age, BMI, albumen, hemoglobin and hematocrites. The alimentary standard was adapted
to take account of nutritional necessities of patients, and an algorithm was proposed for the transition of enteric nutritional therapy by mouth to occur assuring
a good enough nutritional supply. We may conclude that the assistance to dysphagic patients was realigned on the basis of the analysis carried through and the
development of strategies for nutritional intervention, guaranteeing quality assistance.