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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Avaliação subjetiva global e bioimpedância elétrica na avaliação nutricional pré-operatória: métodos comparáveis ou complementares?

Barbosa-Silva, Maria Cristina Gonzalez 01 June 1999 (has links)
Submitted by Leonardo Lima (leonardoperlim@gmail.com) on 2017-04-17T19:24:09Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) dissert maria cristina Barbosa e Silva.pdf: 465402 bytes, checksum: 97f6dfddaa8df141b4dd02f52b00f2af (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2017-05-10T15:09:30Z (GMT) No. of bitstreams: 2 dissert maria cristina Barbosa e Silva.pdf: 465402 bytes, checksum: 97f6dfddaa8df141b4dd02f52b00f2af (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2017-05-10T15:12:35Z (GMT) No. of bitstreams: 2 dissert maria cristina Barbosa e Silva.pdf: 465402 bytes, checksum: 97f6dfddaa8df141b4dd02f52b00f2af (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-05-10T15:12:50Z (GMT). No. of bitstreams: 2 dissert maria cristina Barbosa e Silva.pdf: 465402 bytes, checksum: 97f6dfddaa8df141b4dd02f52b00f2af (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 1999-06-01 / Sem bolsa / Objetivos: Com o objetivo de comparar a avaliação subjetiva global com a bioimpedância elétrica como métodos de avaliação nutricional, foram estudados de forma prospectiva 279 pacientes candidatos à cirurgia eletiva do aparelho digestivo. Métodos: Os pacientes foram avaliados durante as primeiras 72 horas de internação, sendo a avaliação subjetiva global realizada segundo Detzky e a bioimpedância elétrica segundo padronização de Lukaski. Foram calculados os seguintes índices pela bioimpedância elétrica: massa celular corporal em kg e em percentual do peso atual, razão massa extra celular/massa celular corporal (MEC/MCC), Nae/Ke, ângulo de fase(AF) e coeficiente de impedância elétrica (CIE), utilizando como pontos de corte os valores citados na literatura. Resultados: Não houve boa concordância entre os resultados obtidos pela avaliação subjetiva global e bioimpedância elétrica, sendo a melhor concordância obtida entre as mulheres, com a razão MEC/MCC maior 1,22 e AF. As médias dos diversos parâmetros da bioimpedância elétrica, no entanto, mostraram que, com exceção do percentual de massa celular corporal, todos os parâmetros aumentaram ou diminuíram conforme piora do estado nutricional segundo avaliação subjetiva global. A construção de curvas ROC para o AF e CIE mostraram que os pontos de corte da literatura utilizados tornam o teste muito sensível ou específico. Nenhum ponto de corte alternativo fornece ao teste sensibilidade e especificidade adequadas. Porém é possível estabelecer pontos de corte com alta sensibilidade e especificidade para que o método seja usado para rastreamento dos pacientes hospitalizados com desnutrição. Conclusões: Embora os métodos não sejam comparáveis, a avaliação subjetiva global e a bioimpedância elétrica podem ser complementares na avaliação do estado nutricional em pacientes cirúrgicos. / Objective: The objective was to compare subjective global assessment and bioelectrical impedance analysis. We studied 279 patients in a prospective way, who were planned to have an elective gastrointestinal surgical procedure. Design: Patients were evaluated during the first 72 hours after admission. Subjective global assessment was performed according to Detzky and bioelectrical impedance analysis according to Lukaski. It was obtained from bioelectrical impedance the indexes: body cell mass in kg and as current weight percentage, extracellular mass/body cell mass ratio (ECM/BCM), Nae/Ke ratio, phase angle (PA) and electric impedance coeficient (EIC), using values mentioned in literature as cut-off values. Results: There was not a good agreement between subjective global assessment and bioelctrical impedance analysis results. The best agreement was obtained in women, with ECM/BCM above 1,22 and PA. Nevertheless, the bioelectrical parameters average showed that, except body cell mass pencentage, all of them increased or decreased as nutritional status became worse by subjective global assessment. The PA and EIC ROC curves showed a too sensitive or too specific test were resulted by using that cut-off values. No one alternative cut-off values gave an appropiate sensitivity and specificity to the test. However, it's possible to determine high sensitivity and specificity cut-off points to use it as a malnutrition screening test in hospitalized patients. Conclusions: Although they are not comparable methods, subjective global assessment and bioelectrical impedance analysis may be complemental in nutritional assessment of sugical patients.

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