Banca de DEFESA: RAMONA SOUZA DA SILVA BAQUEIRO BOULHOSA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : RAMONA SOUZA DA SILVA BAQUEIRO BOULHOSA
DATA : 09/07/2021
HORA: 14:00
LOCAL: online sala virtual google meet
TÍTULO:

Development and validation of an instrument of
Specific nutritional evaluation for patients with
Advanced chronic hepatic disease

PALAVRAS-CHAVES:

Advanced Chronic Liver Disease; malnutrition; nutritional assessment

PÁGINAS: 174
GRANDE ÁREA: Ciências da Saúde
ÁREA: Nutrição
SUBÁREA: Desnutrição e Desenvolvimento Fisiológico
RESUMO:

Malnutrition in patients with advanced chronic liver disease (ACLD) is multifactorial and is associated with a higher incidence of complications and mortality. Thus, early detection of nutritional disorders in these patients is necessary, in order to favor nutritional interventions that minimize the impact of these changes on the clinical course of the disease. However, the available screening and nutritional assessment tools have low sensitivity, since they underestimate the presence of malnutrition and detect it late. Objectives: Develop and validate the Specific Nutritional Evaluation – Advanced Chronic Liver Disease (SNE-ACLD); compare two nutritional screening tools – Nutritional Risk Screening (NRS-2002) and the Royal Free Hospital Nutritional Prioritization Tool (RFH-NPT) with the Global Leadership Initiative on Malnutrition (GLIM) malnutrition diagnostic criteria; to verify the predictive capacity of mortality of different methods of screening and nutritional diagnosis in patients with ACLD. Method: The Delphi methodology was used to validate the content of the SNEACLD, based on the consensus of experts in the field of nutrition and hepatology. Adult and elderly patients with ACLD, hospitalized and outpatient, had their nutritional status assessed using the following methods: NRS-2002, RFH-NPT, Subjective Global Assessment (SGA), Arm Muscle Circumference (AMC), Skinfold triciptal (TSF) and SNE-ACLD. Results: The final version of the SNEACLD consists of 5 domains, 10 items, with scores ranging from 0 to 40. The new instrument showed good accuracy in identifying malnutrition. RFH-NPT showed better agreement with diagnosis according to GLIM criteria (k=0.64; 95%CI 0.52- 0.75), higher sensitivity (80%), higher negative predictive value (79%) and higher AUC ( 82.3%) compared to NRS-2002. In the sub-sample of hospitalized patients, malnutrition, diagnosed by the SGA, and high nutritional risk, identified by the RFH-NPT, were associated with longer hospital stays, in-hospital and 12-month mortality. Conclusion: The RFH-NPT is the nutritional screening method that has shown the best validity for identifying nutritional risk in patients with ACLD. SNEACLD can be used to assess the nutritional status of patients with ACLD, but other validation steps are needed to improve its performance in clinical practice.

MEMBROS DA BANCA:
Presidente - 1107819 - ROSANGELA PASSOS DE JESUS
Interna - 1137078 - LILIAN BARBOSA RAMOS
Externa à Instituição - Valesca Dall'Alba
Externa à Instituição - Giliane Belarmino
Externa à Instituição - LOURIANNE NASCIMENTO CAVALCANTE