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Previous issue date: 2016-05-31 / The Mini Nutritional Assessment Short Form (MNA?-SF) is a nutritional status-screening tool in the elderly including body mass index or calf circumference as anthropometric parameter. However, it is not always possible to obtain these parameters. Thus, it is important to search for alternative parameters such as the circumference of the arm that is also used in the evaluation of nutritional status. This dissertation presents an original article entitled ACCURACY OF ARM CIRCUMFERENCE IN THE MINI NUTRITIONAL ASSESSMENT SHORT FORM whose objectives were to describe the nutritional status of elderly patients in primary health care and determine the accuracy of the use of the arm circumference in MNA?-SF for screening of nutritional status. Therefore, a cross-sectional, descriptive and analytical study was conducted, with a sample of 539 individuals aged 60 years or more, registered in the Family Healthcare in Porto Alegre-RS and were evaluated in the Epidemiological and Clinical Study Seniors Attended by the Family Healthcare in the City of Porto Alegre (EMI-SUS). Variables were investigated, such as Socio-demographic (genre, age, race, marital status, family income and education); Anthropometric [body mass index (BMI), calf circumference (CC) and arm circumference (AC)] and nutritional status (MNA? and MNA?-SF). For the classification of the AC, two variations were used, one with three categories (AC3= <21cm: 0 points; ?21 or ?22cm: 1.5 points; >22cm: 3 points) and one with two categories (AC2= < 21cm: 0 points and ?21: 3 points), taking into account the minimum and maximum values established for categories of BMI of MNA? due to its replacement by AC2, AC3. For CC, the cutoff points used were already determined to MNA?-SF (<31cm: 0 points; ?31cm: 3 points). To determine the accuracy, MNA? was considered the gold standard for nutritional risk. The mean age was 68.7 ? 6.8 years (60-100 years). Most seniors were female (63.1%). Regarding nutritional status, they were classified as being at nutritional risk or undernourished, 24.1% of the elderly by MNA? and 33.4% by MNA?-SF. Regarding the socio-demographic variables, association only between nutritional status and marital status and education was observed. Separate individuals were more often eutrophic and widowers and illiterates were more often malnourished. Correlation analysis between BMI, CC and AC was significant, positive and strong (r> 0.750, P <0.001). The agreement between the MNA?-SF with IMC and MNA?-SF with CC, MNA?-SF with IMC and MNA?-SF with AC2, MNA?-SF with IMC and MNA?-SF with AC3 was excellent (?>0.90; P<0.001). The accuracy of the four instruments showed that they all had high accuracy [MNA?-SF with IMC (aucROC= 0.940), MNA?-SF with CP (aucROC = 0.932), MNA?-SF with CB2 (aucROC = 0.926) and MNA?-SF with CB3 (aucROC = 0.927)], with good sensitivity. Thus, it can be concluded that the use of the arm circumference in MNA?-SF proved accurate for tracking the nutritional status of elderly assisted in the Family Healthcare. / A Mini Avalia??o Nutricional Vers?o Reduzida (MNA?-SF) ? um instrumento de rastreio do estado nutricional de idosos que inclui o ?ndice de massa corporal ou a circunfer?ncia da panturrilha como par?metro antropom?trico. Contudo, nem sempre ? poss?vel obter esses par?metros. Dessa forma, torna-se importante a busca por par?metros alternativos, como a circunfer?ncia do bra?o que tamb?m ? utilizada na avalia??o do estado nutricional. Nesta disserta??o ? apresentado um artigo original intitulado ACUR?CIA DA CIRCUNFER?NCIA DO BRA?O NA MINI AVALIA??O NUTRICIONAL VERS?O REDUZIDA cujos objetivos foram descrever o estado nutricional de idosos atendidos na aten??o b?sica ? sa?de e determinar a acur?cia da utiliza??o da circunfer?ncia do bra?o na MNA?-SF para rastreio do estado nutricional. Para tanto, foi realizado um estudo transversal, descritivo-anal?tico, com uma amostra constitu?da por 539 individuos, com 60 anos ou mais, cadastrados na Estrat?gia Sa?de da Fam?lia de Porto Alegre-RS e que foram avaliados no Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (EMI-SUS). Foram investigadas vari?veis sociodemograficas (g?nero, idade, faixa et?ria, ra?a, estado civil, renda familiar e escolaridade); antropom?tricas [?ndice de massa corporal (IMC), circunfer?ncia da panturrilha (CP) e circunfer?ncia do bra?o (CB)] e do estado nutricional (MNA? e MNA?-SF). Para a classifica??o da CB, foram usadas duas varia??es, uma com tr?s categorias (CB3= <21cm: 0 pontos; ?21 ou ?22cm: 1,5 pontos; >22cm: 3 pontos) e outra com duas categorias (CB2= <21cm: 0 pontos e ?21: 3 pontos), levando-se em considera??o os valores m?nimos e m?ximos estabelecidos para as categorias do IMC da MNA? em fun??o de sua substitui??o por CB2, CB3. Para a CP, foram utilizados os pontos de corte j? determinados para a MNA?-SF (<31cm: 0 pontos; ?31cm: 3 pontos). Para determina??o da acur?cia, a MNA? foi considerada padr?o-ouro para risco nutricional. A m?dia da idade foi de 68,7?6,8 anos, (60-100 anos). A maioria dos idosos era do sexo feminino (63,1%). Quanto ao estado nutricional, foram classificados como sob risco nutricional ou desnutridos 24,1% dos idosos pela MNA? e 33,4% pela MNA?-SF. Em rela??o ?s vari?veis sociodemograficas, observou-se associa??o somente entre estado nutricional e estado civil e escolaridade. ?ndividuos separados eram mais frequentemente eutr?ficos e vi?vos e analfabetos eram mais frequentemente desnutridos. A an?lise de correla??o entre IMC, CP e CB mostrou-se significativa, positiva e forte (r>0,750; P<0,001). A concord?ncia entre os instrumentos MNA?-SF com IMC e MNA?-SF com CP, MNA?-SF com IMC e MNA?-SF com CB2, MNA?-SF com IMC e MNA?-SF com CB3 foi excelente (?>0,90; P<0,001). A acur?cia dos quatro instrumentos mostrou que todos tinham alta precis?o [MNA?-SF com IMC (aucROC= 0,940), MNA?-SF com CP (aucROC= 0,932), MNA?-SF com CB2 (aucROC= 0,926) e MNA?-SF com CB3 (aucROC= 0,927)], com boa sensibilidade. Dessa forma, pode-se concluir que a utiliza??o da circunfer?ncia do bra?o na MNA?-SF mostrou-se acurada para rastreio do estado nutricional de idosos atendidos na Estrat?gia Sa?de da Fam?lia.
Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7123 |
Date | 31 May 2016 |
Creators | Seibel, Raquel |
Contributors | Terra, Newton Luiz, 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, Instituto de Geriatria e Gerontologia |
Source Sets | IBICT Brazilian ETDs |
Language | Portuguese |
Detected Language | English |
Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
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, 600, 600, 600, 2296420844541114010, -969369452308786627 |
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