Triagem nutricional por meio da avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) em câncer ginecológico
10.15343/0104-7809.202246054063
Palavras-chave:
Avaliação Nutricional. Estado Nutricional. Desnutrição. Neoplasias. Ginecologia.Resumo
O câncer é considerado importante causa de morbimortalidade, estando relacionado ao comprometimento da condição nutricional, que por sua vez, repercute diretamente no manejo clínico e na qualidade de vida. Neste contexto, buscou-se identificar o estado nutricional de mulheres com câncer ginecológico e investigar a associação do estado nutricional por triagem nutricional específica com o estado nutricional pelo índice de massa corporal (IMC), faixa etária e características clínicas através de um estudo transversal, realizado nas enfermarias de ginecologia e oncologia de um hospital universitário, durante julho a dezembro de 2017. Foram avaliadas pacientes com idade ≥ 20 anos, diagnosticadas com câncer ginecológico. O estado nutricional foi identificado utilizando-se a avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) que classifica em bem nutrido, desnutrição moderada ou desnutrição grave. A altura e peso atual foram obtidos através de balança mecânica e o peso usual foi referido pelas pacientes, sendo utilizados na determinação do IMC e no percentual de peso perdido. Foram estudadas 60 mulheres, com idade média de 54,5 ± 14,17 anos, com diagnóstico predominante de câncer de útero (68,3%). O estadiamento IV foi o mais prevalente (65%), a frequência de desnutrição foi elevada (68,3%), principalmente entre as idosas (81,5%), a perda ponderal ocorreu em 60% do grupo e a necessidade de intervenção nutricional em 91,7% dos casos. Constatou-se nesta amostra de mulheres adultas e idosas, elevada frequência de desnutrição através da ASG-PPP, esses achados ressaltam a importância desta ferramenta na identificação do estado nutricional em pacientes com câncer ginecológico.
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Referências
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11. Mendes NP, Barros TA, Rosa C, Franceschini S. Nutritional screening tools used and validated for cancer patients: a systematic review. Nutr Cancer. 2019; 71(6): 898–907. Available from: https://doi.org/10.1080/01635581.2019.1595045
12. Xu YC, Vincent JI. Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review. Nutr J. 2020; 19(1). Available from: http://dx.doi.org/10.1186/s12937-020-00613-0
13. Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition. 1996; 12(1): 15-19. Available from: https://doi.org/10.1016/0899-9007(95)00067-4
14. Gonzalez MC, Borges LR, Silveira DH, Assunção MCF, Orlandi SP. Validação da versão em português da avaliação subjetiva global produzida pelo paciente. Rev bras nutr clín. 2010; 25(2): 102-8.
15. Jager-Wittenaar H, Ottery FD. Assessing nutritional status in cancer: role of the patient-generated subjective global assessment. Curr Opin Clin Nutr Metab Care. 2017; 20(5): 322–29. Available from: https://doi.org/10.1097/MCO.0000000000000389
16. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. Geneva: World Health Organization; 2000.
17. Organización Panamericana de la Salud. División de Promoción y Protección de la Salud. Encuesta Multicentrica salud beinestar y envejecimiento (SABE) en América Latina el Caribe: Informe Preliminar [Internet]. Kingston, Jamaica: OPAS, 2002. [acceso en 14 jun 2017] Disponible en: https://www1.paho.org/Spanish/HDP/HDR/CAIS-01-05.PDF
18. Rodrigues CS, Lacerda MS, Chaves GV. Patient generated subjective global assessment as a prognosis tool in women with gynecologic cancer. Nutrition. 2015; 31(11-12): 1372–78. Available from: https://doi.org/10.1016/j.nut.2015.06.001
19. Das U, Patel S, Dave K, Bhansali R. Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters. South Asian J Cancer. 2014; 3(1): 38–42. Available from: https:// doi.org/10.4103/2278-330X.126518
20. Oliveira RCS, Soares BLM, Maio R, Santos AMS, Burgos MGPA. Associações do risco nutricional com tempo de internamento e complicações hospitalares: estudo em pacientes de ginecologia do ne do brasil. Nutr clín diet hosp. 2020; 40(4): 77-83. Disponível em: http://dx.doi.org/10.12873/404goretti
21. Gonzalez MC, Correia M, Heymsfield SB. A requiem for BMI in the clinical setting. Curr Opin Clin Nutr Metab Care. 2017; 20(5): 314–21. Available from: https://doi.org/10.1097/MCO.0000000000000395
22. Vliet IMV, Gomes-Neto AW, de Jong M, Bakker S, Jager-Wittenaar H, Navis GJ. Malnutrition screening on hospital admission: impact of overweight and obesity on comparative performance of MUST and PG-SGA SF. Eur J Clin Nutr. 2021; 75: 1398–1406. Available from: https://doi.org/10.1038/s41430-020-00848-4
23. Zhang YH, Xie FY, Chen YW, Wang HX, Tian WX, Sun WG, et al. Evaluating the nutritional status of oncology patients and its association with quality of life. Biomed Environ Sci. 2018; 31(9): 637–44. Available from: https://doi.org/10.3967/ bes2018.088
24. Plyta M, Patel PS, Fragkos KC, Kumagai T, Mehta S, Rahman F, et al. Nutritional status and quality of life in hospitalised cancer patients who develop intestinal failure and require parenteral nutrition: an observational study. Nutrients [Internet]. 2020; 12(8): 2357 p. Available from: http://dx.doi.org/10.3390/nu12082357
25. Santos AF, Rabelo Junior AA, Campos FLB, Sousa RML, Veloso HJF, Chein MBC. Scored patient-generated subjective global assessment: length of hospital stay and mortality in cancer patients. Rev Nutr (Online). 2017; 30(5): 545-53. Disponível em: http://dx.doi.org/10.1590/1678-98652017000500001
26. Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the scored patient-generated subjective global assessment (PG-SGA) in thai setting and association with nutritional parameters in cancer patients. Asian Pac J Cancer Prev. 2019; 20(4): 1249-55. Available from: http://dx.doi.org/10.31557/apjcp.2019.20.4.1249
27. Chantragawee C, Achariyapota V. Utilization of a scored patient-generated subjective global assessment in detecting a malnourished status in gynecologic cancer patients. Asian Pac J Cancer Prev. 2016; 17(9): 4401–04. Available from: http:// journal.waocp.org/article_38767_9cd8cce7b36109278afc136a8751b014.pdf
28. Balogun N, Forbes A, Widschwendter M, Lanceley A. Noninvasive nutritional management of ovarian cancer patients: beyond intestinal obstruction. Int J Gynecol Cancer. 2012; 22(6): 1089–95. Available from: https://doi.org/10.1097/ IGC.0b013e318256e4d3
29. Schiessel DL, Orrutéa AKG, Silva SE, Cavagnari MAV, Mazur CE, Gavarrete DD, et al. Perda de peso em pacientes oncológicos: prevalência e prognóstico relacionados a sexo, idade, localização do tumor e sintomas de impacto nutricional. Braspen J. 2020; 35(1): 84-92. Disponível em: http://dx.doi.org/10.37111/braspenj.2020351014
30. de Pinho NB, Martucci RB, Rodrigues VD, D'Almeida CA, Thuler L, Saunders C, et al. High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: results of a Brazilian multicenter study. Cancer. 2020; 126(1): 156–64. Available from: https://doi.org/10.1002/cncr.32437
31. Wiegert E, Padilha PC, Peres W. Performance of patient-generated subjective global assessment (PG-SGA) in patients with advanced cancer in palliative care. Nutr Clin Pract. 2017; 32(5): 675–81. Available from: https://doi. org/10.1177/0884533617725071
32. Andrew IM, Waterfield K, Hildreth AJ, Kirkpatrick G, Hawkins C. Quantifying the impact of standardized assessment and symptom management tools on symptoms associated with cancer-induced anorexia cachexia syndrome. Palliat Med. 2009; 23(8): 680–88. Available from: https://doi.org/10.1177/0269216309106980
33. Gomes NS, Maio R. Avaliação subjetiva global produzida pelo próprio paciente e indicadores de risco nutricional no paciente oncológico em quimioterapia. Rev Bras Cancerol. 2015; 61(3): 235-42. Disponível em: https://pesquisa.bvsalud.org/ portal/resource/pt/biblio-833863
34. Campos MPO, Hassan BJ, Riechelmann R, Giglio A. Fadiga relacionada ao câncer: uma revisão. Rev Assoc Med Bras 2011; 57(2): 211-19. Disponível em: http://dx.doi.org/10.1590/s0104-42302011000200021
2. Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de Câncer no Brasil. Ministério da Saúde; 2019. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020- incidencia-de-cancer-no-brasil.pdf
3. Pal SK, Miller MJ, Agarwal N, Chang SM, Chavez-Macgregor M, Cohen E, et al. Clinical cancer advances 2019: annual report on progress against cancer from the american society of clinical oncology. J Clin Oncol. 2019; 37(10): 834-49. Available from: http://dx.doi.org/10.1200/jco.18.02037
4. Shirali E, Yarandi F, Ghaemi M, Montazeri A. Quality of life in patients with gynecological cancers: a web-based study. Asian Pac J Cancer Prev. 2020; 21(7): 1969–75. Available from: https://doi.org/10.31557/APJCP.2020.21.7.1969
5. Koo MM, Swann R, Mcphail S, Abel GA, Elliss-Brookes L, Rubin GP, et al. Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. Lancet Oncol. 2020; 21(1): 73-9. Available from: http:// dx.doi.org/10.1016/s1470-2045(19)30595-9
6. Dilley J, Burnell M, Gentry-Maharaj A, Ryan A, Neophytou C, Apostolidou S, et al. Ovarian cancer symptoms, routes to diagnosis and survival - Population cohort study in the 'no screen' arm of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Gynecol Oncol. 2020; 158(2): 316-322. Available from: https://doi.org/10.1016/j.ygyno.2020.05.002
7. Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr ESPEN. 2017; 36(5): 1187-96. Available from: http://dx.doi.org/10.1016/j. clnu.2017.06.017
8. Marshall KM, Loeliger J, Nolte L, Kelaart A, Kiss NK. Prevalence of malnutrition and impact on clinical outcomes in câncer services: a comparison of two time points. Clin Nutr ESPEN. 2019; 38(2): 644–51. Available from: https://doi.org/10.1016/j. clnu.2018.04.007
9. Instituto Nacional de Câncer José Alencar Gomes da Silva. Inquérito brasileiro de nutrição oncológica. Ministério da Saúde; 2013.
10. Zorlini R, Cairo AA, Gurgel SC. Nutritional status of patients with gynecologic and breast cancer. Nutr Hosp. [Internet]. 2008 Dic [citado 2021 Abr 10]; 23(6): 577-583. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212- 16112008000800009&lng=es
11. Mendes NP, Barros TA, Rosa C, Franceschini S. Nutritional screening tools used and validated for cancer patients: a systematic review. Nutr Cancer. 2019; 71(6): 898–907. Available from: https://doi.org/10.1080/01635581.2019.1595045
12. Xu YC, Vincent JI. Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review. Nutr J. 2020; 19(1). Available from: http://dx.doi.org/10.1186/s12937-020-00613-0
13. Ottery FD. Definition of standardized nutritional assessment and interventional pathways in oncology. Nutrition. 1996; 12(1): 15-19. Available from: https://doi.org/10.1016/0899-9007(95)00067-4
14. Gonzalez MC, Borges LR, Silveira DH, Assunção MCF, Orlandi SP. Validação da versão em português da avaliação subjetiva global produzida pelo paciente. Rev bras nutr clín. 2010; 25(2): 102-8.
15. Jager-Wittenaar H, Ottery FD. Assessing nutritional status in cancer: role of the patient-generated subjective global assessment. Curr Opin Clin Nutr Metab Care. 2017; 20(5): 322–29. Available from: https://doi.org/10.1097/MCO.0000000000000389
16. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. Geneva: World Health Organization; 2000.
17. Organización Panamericana de la Salud. División de Promoción y Protección de la Salud. Encuesta Multicentrica salud beinestar y envejecimiento (SABE) en América Latina el Caribe: Informe Preliminar [Internet]. Kingston, Jamaica: OPAS, 2002. [acceso en 14 jun 2017] Disponible en: https://www1.paho.org/Spanish/HDP/HDR/CAIS-01-05.PDF
18. Rodrigues CS, Lacerda MS, Chaves GV. Patient generated subjective global assessment as a prognosis tool in women with gynecologic cancer. Nutrition. 2015; 31(11-12): 1372–78. Available from: https://doi.org/10.1016/j.nut.2015.06.001
19. Das U, Patel S, Dave K, Bhansali R. Assessment of nutritional status of gynecological cancer cases in India and comparison of subjective and objective nutrition assessment parameters. South Asian J Cancer. 2014; 3(1): 38–42. Available from: https:// doi.org/10.4103/2278-330X.126518
20. Oliveira RCS, Soares BLM, Maio R, Santos AMS, Burgos MGPA. Associações do risco nutricional com tempo de internamento e complicações hospitalares: estudo em pacientes de ginecologia do ne do brasil. Nutr clín diet hosp. 2020; 40(4): 77-83. Disponível em: http://dx.doi.org/10.12873/404goretti
21. Gonzalez MC, Correia M, Heymsfield SB. A requiem for BMI in the clinical setting. Curr Opin Clin Nutr Metab Care. 2017; 20(5): 314–21. Available from: https://doi.org/10.1097/MCO.0000000000000395
22. Vliet IMV, Gomes-Neto AW, de Jong M, Bakker S, Jager-Wittenaar H, Navis GJ. Malnutrition screening on hospital admission: impact of overweight and obesity on comparative performance of MUST and PG-SGA SF. Eur J Clin Nutr. 2021; 75: 1398–1406. Available from: https://doi.org/10.1038/s41430-020-00848-4
23. Zhang YH, Xie FY, Chen YW, Wang HX, Tian WX, Sun WG, et al. Evaluating the nutritional status of oncology patients and its association with quality of life. Biomed Environ Sci. 2018; 31(9): 637–44. Available from: https://doi.org/10.3967/ bes2018.088
24. Plyta M, Patel PS, Fragkos KC, Kumagai T, Mehta S, Rahman F, et al. Nutritional status and quality of life in hospitalised cancer patients who develop intestinal failure and require parenteral nutrition: an observational study. Nutrients [Internet]. 2020; 12(8): 2357 p. Available from: http://dx.doi.org/10.3390/nu12082357
25. Santos AF, Rabelo Junior AA, Campos FLB, Sousa RML, Veloso HJF, Chein MBC. Scored patient-generated subjective global assessment: length of hospital stay and mortality in cancer patients. Rev Nutr (Online). 2017; 30(5): 545-53. Disponível em: http://dx.doi.org/10.1590/1678-98652017000500001
26. Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the scored patient-generated subjective global assessment (PG-SGA) in thai setting and association with nutritional parameters in cancer patients. Asian Pac J Cancer Prev. 2019; 20(4): 1249-55. Available from: http://dx.doi.org/10.31557/apjcp.2019.20.4.1249
27. Chantragawee C, Achariyapota V. Utilization of a scored patient-generated subjective global assessment in detecting a malnourished status in gynecologic cancer patients. Asian Pac J Cancer Prev. 2016; 17(9): 4401–04. Available from: http:// journal.waocp.org/article_38767_9cd8cce7b36109278afc136a8751b014.pdf
28. Balogun N, Forbes A, Widschwendter M, Lanceley A. Noninvasive nutritional management of ovarian cancer patients: beyond intestinal obstruction. Int J Gynecol Cancer. 2012; 22(6): 1089–95. Available from: https://doi.org/10.1097/ IGC.0b013e318256e4d3
29. Schiessel DL, Orrutéa AKG, Silva SE, Cavagnari MAV, Mazur CE, Gavarrete DD, et al. Perda de peso em pacientes oncológicos: prevalência e prognóstico relacionados a sexo, idade, localização do tumor e sintomas de impacto nutricional. Braspen J. 2020; 35(1): 84-92. Disponível em: http://dx.doi.org/10.37111/braspenj.2020351014
30. de Pinho NB, Martucci RB, Rodrigues VD, D'Almeida CA, Thuler L, Saunders C, et al. High prevalence of malnutrition and nutrition impact symptoms in older patients with cancer: results of a Brazilian multicenter study. Cancer. 2020; 126(1): 156–64. Available from: https://doi.org/10.1002/cncr.32437
31. Wiegert E, Padilha PC, Peres W. Performance of patient-generated subjective global assessment (PG-SGA) in patients with advanced cancer in palliative care. Nutr Clin Pract. 2017; 32(5): 675–81. Available from: https://doi. org/10.1177/0884533617725071
32. Andrew IM, Waterfield K, Hildreth AJ, Kirkpatrick G, Hawkins C. Quantifying the impact of standardized assessment and symptom management tools on symptoms associated with cancer-induced anorexia cachexia syndrome. Palliat Med. 2009; 23(8): 680–88. Available from: https://doi.org/10.1177/0269216309106980
33. Gomes NS, Maio R. Avaliação subjetiva global produzida pelo próprio paciente e indicadores de risco nutricional no paciente oncológico em quimioterapia. Rev Bras Cancerol. 2015; 61(3): 235-42. Disponível em: https://pesquisa.bvsalud.org/ portal/resource/pt/biblio-833863
34. Campos MPO, Hassan BJ, Riechelmann R, Giglio A. Fadiga relacionada ao câncer: uma revisão. Rev Assoc Med Bras 2011; 57(2): 211-19. Disponível em: http://dx.doi.org/10.1590/s0104-42302011000200021
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Publicado
2022-05-09
Como Citar
Melo dos Santos, E. T., Alves Neris, V., Nascimento da Silva, T. V., Albuquerque Queiroz, P. M., Maio, R., & Pessoa de Araújo Burgos, M. G. (2022). Triagem nutricional por meio da avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) em câncer ginecológico: 10.15343/0104-7809.202246054063. O Mundo Da Saúde, 46, 054–063. Recuperado de https://revistamundodasaude.emnuvens.com.br/mundodasaude/article/view/1320
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