Percentual de perda de peso e dobra cutânea tricipital : parâmetros confiáveis para o diagnóstico de desnutrição em pacientes com neoplasia periampolar - avaliação nutricional pré-operatória

Objetivos: identificar os metodos de avaliacao nutricional pre-operatoria que possam diagnosticar a desnutricao em pacientes com neoplasia periampolar. Metodos: estudo prospectivo com 29 pacientes submetidos a cirurgia no Hospital de Clinicas de Porto Alegre. As avaliacoes foram realizadas no pre-operatorio e incluiam dados antropometricos, bioquimicos e clinicos. Resultados: dos pacientes analisados 86% apresentaram perda de peso, destes 88% foram classificados com perda de peso grave, a media de perda de peso foi de 13,81%. A dobra cutânea tricipital mostrou desnutricao e perda de massa magra em 25 pacientes (86%), em relacao a dobra cutânea subescapular 19 pacientes tiveram diminuicao da massa magra e foram classificados como desnutridos. Em relacao a circunferencia muscular do braco e a circunferencia do braco identificou-se 7 (24%) e 5 (17%) pacientes com desnutricao, respectivamente. Na avaliacao bioquimica a concentracao serica de albumina, transferrina e contagem total de linfocitos indicou reducao correspondente a desnutricao em 12 (41%), 20 (69%) e 18 pacientes (62%) respectivamente. Quinze deles (52%) tinham diagnostico de diabetes mellitus. Conclusao: todos os pacientes apresentaram alguma variavel nutricional alterada, mas o indice de massa corporal e a dosagem de albumina demonstraram alteracao com menor frequencia enquanto que o percentual de perda de peso e a dobra cutânea tricipital mostraram a maior capacidade para detectar desnutricao. Aim: to identify methods of preoperative nutritional assessment that can establish the diagnosis of malnutrition in patients with periampullary cancer. Methods: prospective study with 29 patients undergoing surgery in the Hospital de Clinicas de Porto Alegre. Assessments were performed during the preoperative period and included anthropometric, biochemical, and clinical data. Results: eighty-six percent of the patients showed weight loss, and 88% of these were classified as severe weight loss, while their mean weight loss was 13.81%. Triceps skinfold thickness revealed malnutrition and lean body mass decrease in 25 patients (86%); in relation to the subscapular skinfold thickness, 19 patients had lean body mass decrease and were classified as malnourished. In terms of arm muscle circumference and arm circumference, 7 (24%) and 5 (17%) patients had malnutrition, respectively. In the biochemical evaluation, serum albumin, transferrin and lymphocytes total count decreased suggesting malnutrition in 12 (41%), 20 (69%) e 18 (62%) patients, respectively. Fifteen patients (52%) had diabetes mellitus. Conclusion: all patients were found to have some degree of malnutrition. Body mass index and serum albumin level showed to be the least sensitive among the parameters used, whereas weight loss percentage and triceps skinfold thickness had the highest sensitivity for malnutrition in these patients.