Hand Grip Strength and nutritional status in hospitalized oncological patients
Palavras-chave:
Handgrip Strength, Nutritional status, Hospitalized patients, NeoplasmsResumo
Objective
To evaluate the nutritional status and functional capacity of hospitalized adult patients.
Methods
Cross-sectional study of adult oncology patients at Hospital de Clínicas de Porto Alegre. Patients were evaluated according to Solid Tumors and Hematologic Tumors. The nutritional status was obtained using Patient Generated Subjective Global Assessment, and the functional capacity was evaluated by Handgrip Strength using a Jamar® dynamometer – and the Performance Index of the Eastern Cooperative Oncology Group.
Results
This study evaluated 76 patients (56±17 years old, 35.5% female), 63.2% with Solid Tumors and 36.8% with Hematologic Tumors. According to the Patient Generated Subjective Global Assessment, 53.9% of the patients were moderately and severely malnourished and demonstrated functional capacity, according to the Handgrip Strength and Performance Index of the Eastern Cooperative Oncology Group, of 47.9% and 32.2%, respectively. The functional capacity instruments showed a moderate agreement (Kappa=0.427, p<0.001) and positive correlation (r=0.136, p=0.028). Severely malnourished patients had a lower Handgrip Strength when compared to well nourished (24.0±10.4 vs. 34.2±16.6kg, p=0.015). The results were confi rmed among moderately and
severely malnourished patients, who were rated at the 40 percentile, considered low functional capacity.
Conclusion
In this study, hospitalized oncological patients presented poor nutritional status and low functional capacity. The Patient Generated Subjective Global Assessment identifies the nutritional specification earlier. In addition, Handgrip Strength dynamometry can be a useful tool to evaluate the low functional capacity and nutritional status. It can be included in cancer patient’s evaluation, along with other nutritional assessment tools.
Referências
National Cancer Institute. 2017 [cited 2018 May 10]. Avaliable from: https://www.cancer.gov/
Torre LA, Bray F, Siegel RL, Ferley J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. Cancer J Clin. 2015;65(2):87-108.
Silva FR, Oliveira MG, Souza AS, Figueroa JN, Santos CS. Factors associated with malnutrition in hospitalized cancer patients: A croos-sectional study. Nutr J. 2015;14(123):1-8.
Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancerrelated malnutrition. Clin Nutr. 2017;36(5):1187-96.
Waitzberg DL, Caiaffa WT, Correia MI. Hospital malnutrition: The Brazilian national survey (IBRANUTRI): A study on 4000 patients. Nutrition. 2001;17:573-80.
Hebuterne X, Lemarie E, Michallet M, Montreuil CB, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enteral Nutr. 2014;38(2):196-204.
Consenso Nacional de Nutrição Oncológica. Instituto Nacional de Câncer. Ministério da Saúde. 2a ed. Rio de Janeiro: INCA; 2016.
Bauer J, Capra S, Ferguson M. Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr. 2002;56:779-85.
Gomes NS, Maio R. Patient-Generated Subjective Global Assessment and nutritional risk Indicators in oncology patients receiving chemotherapy. Rev Bras de Cancerol. 2015;61(3):235-42.
Norman K, Stobäus N, Gonzalez MC, Schulzke J-D, Pirlich M. Hand grip strength: Outcome predictor and marker of nutritional status. Clin Nutr. 2011;30:135-42.
Mendes J, Alves P, Amaral TF. Comparison of nutritional status assessment parameters in predicting length of hospital stay in cancer patients. Clin Nutr. 2014;33:466-70.
Kilgour RD, Vigano A, Trutschnigg B, Lucar E, Borod M, Morais JA. Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients. Support Care Cancer. 2013;21:3261-70.
Gonzalez MC, Borges LR, Silveira DH, Assunção MCF, Orlandi SP. Validação da versão em português da Avaliação Subjetiva Global Produzida pelo Paciente. Rev Bras Nutr Clin. 2010;25:102-8.
Luna-Heredia E, Martín-Penã G, Ruiz-Galiana J. Handgrip dynamometry in healthy adults. Clin Nutr. 2005;24(2):250-8.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of The Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649-55.
Peres GB, Valim GS, Silva VL, El-Kik RM. Comparação entre métodos de Avaliação Subjetiva Global em oncologia. Rev Ciênc Saúde. 2009;2(1):37-42.
Gomes NS, Maio R. Patient-Generated Subjective Global Assessment and nutritional risk indicators in oncology patients receiving chemotherapy. Rev Bras Cancerol. 2015;61(3):235-42.
Instituto Nacional de Câncer. Ministério da Saúde. Inquérito brasileiro de nutrição oncológica. Rio de Janeiro: INCA; 2013.
Guerra RS, Fonseca I, Pichel F, Restivo MT, Amaral TF. Handgrip strength and associated factors in hospitalized patients. J Parenter Enteral Nutr. 2015;39(3):322-30.
White JV, Guenter P, Jensen G, Malone A, Schofield M. Malnutrition task force and the A.S.P.E.N. board of directors. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (Undernutrition). J Parenter Enteral Nutr. 2012;36(3):275-83.
Schlüssel MM, Anjos LA, Vasconcellos MT, Kac G. Reference values of handgrip dynamometry of healthy adults: A population-based study. Clin Nutr. 2008;4:601-7.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23.
Schlüssel MM. Reference values of handgrip dynamometry of healthy adults: A populationbased study. Clin Nutr. 2008;27:601-7.
Budziareck MB, Pureza Duarte RR, Barbosa-Silva MC. Reference values and determinants for handgrip strength in healthy subjects. Clin Nutr. 2008;27:357-62.
Gunther CM, Burger A, Rickert M, Crispin A, Schulz CU. Grip strength in healthy Caucasian adults: Reference values. J Hand Surg Am. 2008; 33:558-65.
Lopes J, Grams ST, Silva EF, Medeiros LA, Brito CMM, Yamaguti WP. Reference equations for handgrip strength: Normative values in young adult and middle-aged subjects. Clin Nutr. 2018;37(3):914-18.
Stessman J, Rottenberg Y, Fischer M, HammermanRozenberg A, Jacobs JM. Handgrip strength in old and very old adults: Mood, cognition, function, and mortality. J Am Geriatr Soc. 2017;65(3):526-32.
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Copyright (c) 2023 Thais STEEMBURGO, Natália Cristina AVERBUCH, Christy Hannah Sanini BELIN, Estela Beatriz BEHLING
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
