Desfecho terapêutico de pacientes em risco nutricional admitidos em um hospital universitário

OBJETIVO: investigar a influencia do risco nutricional, detectado ao inicio da internacao, no desfecho terapeutico de pacientes.METODOS: estudo de coorte prospectiva com 495 pacientes admitidos no pronto-atendimento de um hospital universitario, submetidos a triagem de risco nutricional com base no Nutritional Risk Screening, 2002. Ao final da internacao, buscaram-se os prontuarios para avaliacao do desfecho, complicacoes e presenca da terapia nutricional.RESULTADOS: do total de pacientes, 53,9% eram do sexo feminino, 71,3% tinham idade inferior a 60 anos e 11,7% evoluiram com cuidados paliativos/obito. Segundo o indice de massa corporal, 15,5% dos pacientes foram classificados como desnutridos. O risco nutricional foi encontrado em 54,5% e associou-se fortemente ao desfecho terapeutico cuidados paliativos/obito (HR: 5,92; IC 95%: 2,68-13,08), assim como seus componentes, estresse metabolico da doenca (HR: 3,33; IC 95°%: 1,61-6,86) e estado nutricional prejudicado (moderado = HR: 3,24; IC 95°%: 1,31-8,00; grave = HR: 6,45; IC 95%: 2,36-17,63), apos o ajuste por potenciais fatores de confusao.CONCLUSAO: a prevalencia de risco nutricional detectada foi alta e sua presenca estava relacionada a pior desfecho terapeutico. Objective: To investigate the influence of nutritional risk, detected upon being admitted to a hospital, on therapeutic outcomes in patients. Methods: This prospective cohort study was conducted with 495 patients admitted to the emergency clinic of a public hospital, where they were screened for nutritional risk based on the Nutritional Risk Screening 2002. At the end of hospitalization, the outcome, complications, and the presence of nutritional therapy were evaluated based on the medical records. Results: Of the total patients, 53.9% were female, 71.3% were less than 60 years of age, and 11.7% had the therapeutic outcome of palliative care / death. According to Body Mass Index (BMI), 15.5% of the patients were classified as malnourished. Nutritional risk was found in 54.5%, which correlated strongly with the therapeutic outcome of palliative care/death (HR: 5.92, 95% CI: 2.68 to 13.08) as well as their components of increased nutritional requirements (HR: 3.33, 95% CI: 1.61 to 6.86) and impaired nutritional status (HR = moderate: 3.24, 95% CI: 1.31 to 8.00, severe = HR: 6.45, 95% CI: 2.36 to 17.63) after adjustment for potential confounding factors. Conclusion: The prevalence of nutritional risk detected in the sample was high, and its presence was related to a poor therapeutic outcome.