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Previous issue date: 2017-10-30 / The frequency of malnutrition in hospitalized elderly patients is high and, consequently, generates an increase in morbimortality. In order to identify malnutrition in hospitalized elderly patients, it is necessary to make a nutritional assessment. Some limitations related to the application of traditional nutritional assessment tools used in elderly patients can be seen, like anthropometric parameters and even the Mini Nutritional Assessment? (MNA?) when such patients present physical or mental limitations, what can be an even more serious problem when they are unaccompanied. Thus, in the search for nutritional assessment tools, which do not depend on the patient?s colaboration, are easy to find and inexpensive, the measurement of adductor pollicis muscle thickness (APMT) has been studied as an anthropometric parameter. Several studies have used APMT in elderly patients in different surgical and clinical conditions. Despite that, few studies have included only elderly patients and none has analyzed the association between APMT and MNA? and checked the accuracy of APMT in relation to the nutritional risk and malnutrition, considering MNA? as a gold standard. In this context, this thesis presents three original articles with cross-sectional design. In the first article entitled ADDUCTOR POLLICIS MUSCLE THICKNESS IN HOSPITALIZED ELDERLY PATIENTS: RELATION BETWEEN GENDER AND AGE, it was attempted to relate the adductor pollicis muscle thickness of hospitalized elderly patients to gender and age. In this study, 119 hospitalized elderly patients were assessed and no significant difference of the APMT measurement between the dominant and non-dominant hands was observed and it was also observed that such measurement was bigger in the younger individuals (60 and 79 years old) and the male individuals. In the second article entitled ASSOCIATION BETWEEN ADDUCTOR POLLICIS MUSCLE THICKNESS AND NUTRITIONAL PARAMETERS IN HOSPITALIZED ELDERLY PATIENTS, the association between APMT and nutritional parameters in hospitalized elderly patients was analyzed. In this study, 331 hospitalized elderly patients were assessed and the association between APMT and all the nutritional parameters was investigated (MNA?, calf circumference, arm circumference, body mass index and handgrip strength) regardless of gender and age was observed, what reinforces its applicability in the nutritional assessment of elderly patients. In the third article entitled ADDUCTOR POLLICIS MUSCLE THICKNESS ACCURACY IN THE SCREENING OF NUTRITIONAL RISK AND MALNUTRITION IN HOSPITALIZED ELDERLY PATIENTS. This study, that evaluated 291 elderly people, was attempted to determine the cut-off points of APMT and its accuracy as a tool to screen the nutritional risk and malnutrition in hospitalized elderly patients. It was observed that APMT did not reach satisfactory levels of accuracy for nutritional risk and malnutrition for both men and women. Longitudinal studies are suggested in order to advance in the investigation of the role of APMT in the screening of nutritional risk and malnutrition. / A frequ?ncia de desnutri??o em idosos hospitalizados ? alta e tem como consequ?ncia o aumento da morbimortalidade. Para identificar a desnutri??o em idosos hospitalizados ? necess?rio realizar uma avalia??o nutricional. Podem ser verificadas algumas limita??es na aplica??o de instrumentos de avalia??o nutricional tradicionalmente utilizados em idosos, como os par?metros antropom?tricos e at? mesmo a Mini Avalia??o Nutricional? (MNA?), quando h? presen?a de limita??es f?sicas e mentais no idoso, o que ainda se agrava quando o idoso n?o possui acompanhante. Assim, na busca por instrumentos de rastreio nutricional que n?o dependam da colabora??o do paciente, que sejam de r?pida obten??o e de baixo custo, a medida da Espessura do M?sculo Adutor do Polegar (EMAP) tem sido estudada como um par?metro antropom?trico. Diversos estudos t?m utilizado a EMAP com idosos em diferentes condi??es cl?nicas cir?rgicas. Apesar disso, poucos estudos inclu?ram apenas indiv?duos idosos e nenhum analisou a associa??o entre EMAP e MNA? e verificou a acur?cia da EMAP em rela??o ao risco de desnutri??o e desnutri??o, tendo a MNA? como padr?o-ouro. Nesse contexto, esta tese apresenta tr?s artigos originais com delineamento transversal. No primeiro artigo, intitulado ?Espessura do m?sculo adutor do polegar em idosos hospitalizados: rela??o com sexo e idade?, buscou-se relacionar a espessura do m?sculo adutor do polegar de idosos hospitalizados com sexo e idade. Nesse estudo foram avaliados 119 idosos hospitalizados, e n?o foi observada diferen?a significativa da medida da EMAP entre as m?os dominante e n?o dominante. Essa medida apresentou-se maior nos indiv?duos mais jovens (60-79 anos) e nos do sexo masculino. No segundo artigo, intitulado ?Associa??o entre espessura do m?sculo adutor do polegar e par?metros nutricionais em idosos hospitalizados?, foi analisada a associa??o entre EMAP e par?metros nutricionais em idosos hospitalizados. Nesse estudo, foram avaliados 331 idosos hospitalizados, e constatou-se a associa??o da EMAP com todos os par?metros nutricionais investigados (MNA?, circunfer?ncia da panturrilha, circunfer?ncia do bra?o, ?ndice de massa corporal e for?a de preens?o palmar), independentemente do sexo e da idade, o que refor?a sua aplicabilidade na avalia??o nutricional de idosos. No terceiro artigo, intitulado ?Acur?cia da espessura do m?sculo adutor do polegar no rastreio de risco de desnutri??o e de desnutri??o em idosos hospitalizados?, buscou-se determinar os pontos de corte da EMAP e sua acur?cia como instrumento de rastreio do risco de desnutri??o e de desnutri??o em idosos hospitalizados. Neste estudo, que envolveu a avalia??o de 291 indiv?duos idosos, verificou-se que a EMAP n?o atingiu n?veis satisfat?rios de acur?cia para risco nutricional e desnutri??o em ambos os sexos. Sugere-se a realiza??o de estudos longitudinais para avan?ar na investiga??o do papel da EMAP no rastreio do risco de desnutri??o e de desnutri??o em idosos hospitalizados.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7858 |
| Date | 30 October 2017 |
| Creators | El Kik, Raquel Milani |
| Contributors | Schwanke, Carla Helena Augustin |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 500, -224747486637135387, -969369452308786627 |
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