BRASPEN Journal
https://braspenjournal.org/article/doi/10.37111/braspenj.2017.32.3.08
BRASPEN Journal
Artigo Original

Associação entre desnutrição, escore prognóstico de Glasgow modificado e índice inflamatório nutricional em pacientes com câncer

Association between malnutrition, modified Glasgow prognostic score and nutritional inflammatory index in cancer patients

Naira Marceli Fraga Silva, Ana Cristina Lozzer Barcelos, Elise Passamani Noé, Jamila Tintore Cuzzuol, Katarina Papera Valente, Rafael Araújo Guedes de Moraes, Taís Daiene Russo Hortêncio, Valdete Regina Guandalini6

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Resumo

Introdução: A desnutrição é um achado comum em pacientes oncológicos e sua etiologia é multicausal, sendo influenciada significativamente pela resposta inflamatória sistêmica. Os indicadores de inflamação podem ser ferramentas úteis na avaliação nutricional dos pacientes com câncer. Objetivo: Avaliar a associação entre o Escore Prognóstico de Glasgow modificado e o Índice Inflamatório Nutricional (IIN) com a presença e o grau de desnutrição em pacientes com câncer. Método: Pacientes admitidos em um hospital universitário, com diagnóstico confirmado de câncer, participaram deste estudo. Exames laboratoriais de albumina e proteína C-reativa foram realizados para obtenção do EPGm e do IIN. A avaliação nutricional foi realizada por meio da Avaliação Subjetiva Global. Resultados: Foram avaliados 70 pacientes com idade média de 58,51±14,85 anos, dos quais 50 (71,5%) apresentaram algum grau de desnutrição, enquanto 27 (38,6%) apresentaram desnutrição grave. As categorias de risco do EPGm e do IIN estiveram presentes em 41 (58,6%) e 39 (55,7%) pacientes, respectivamente. O EPGm e o IIN associaram-se à presença da desnutrição (p<0,05). Conclusão: O EPGme o IIN mostraram-se ferramentas úteis, de fácil interpretação, com possibilidade de complementar a avaliação nutricional do paciente oncológico, uma vez que se associaram com a desnutrição.

Palavras-chave

Prognóstico. Avaliação Nutricional. Desnutrição. Neoplasias. Inflamação

Abstract

Introduction: Malnutrition is a common finding in patients with cancer; its etiology is multifactorial and significantly influenced by the systemic inflammatory response. Inflammation indicators can be useful tools in the nutritional assessment of patients with cancer. Objective: We intended to evaluate the association of the modified Glasgow Prognostic Score (mGPS) and the InflammatoryNutritional Index (INI) with the presence and degree of malnutrition in cancer patients. Methods: We evaluated patients who were admitted to university hospital with a confirmed diagnosis of cancer participated in this study. Laboratory tests for albumin and C-reactive protein were conducted to obtain mGPS and INI scores. Nutritional assessment was carried out by subjective global assessment. Results: A total of 70 patients with a mean age of 58.51±14.85 years were evaluated, of which 50 (71.5%) presented some degree of malnutrition, while 27 (38.6%) presented severe malnutrition. The risk categories of mGPS and INI were present in 41 (58.6%) and 39 (55.7%) patients, respectively. Conclusion: Them GPS Score and the INI are simple tools, easy to interpret, with the possibility of complementing the nutritional evaluation of cancer patients, since they were associated with malnutrition.

Keywords

Prognosis. Nutrition Assessment. Malnutrition. Neoplasms. Inflammation

Referências

1. Brasil. Ministério da Saúde. Departamento de Informática do SUS – DATASUS. [Internet]. Sistema de Informações sobre Mortalidade - SIM. Brasília: Ministério da Saúde; 2016. [acesso 2016 Jan 30]. Disponível em: http://tabnet.datasus.gov.br/cgi/ deftohtm.exe?sim/cnv/obt10uf.def

2. Brasil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva. Inquérito Brasileiro de Nutrição Oncológica. Rio de Janeiro: INCA; 2013.

3. Planas M, Álvarez-Hernández J, León-Sanz M, Celaya-Pérez S, Araujo K, García de Lorenzo A; PREDyCES® researchers. Prevalence of hospital malnutrition in cancer patients: a subanalysis of the PREDyCES® study. Support Care Cancer. 2016;24(1):429-35.

4. Deans DA, Tan BH, Wigmore SJ, Ross JA, Beaux AC, PatersonBrown S, et al. The influence of systemic inflammation, dietaryintake and stage of disease on rate of weight loss in patients with gastro-oesophageal cancer. Br J Cancer. 2009;100(1):63-9.

5. Andreyev HJ, Norman AR, Oates J, Cunningham D. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998;34(4):503-9.

6. Scott HR, McMillan DC, Forrest LM, Brown DJ, McArdle CS, Milroy R.The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Br J Cancer. 2002;87(3):264-7.

7. McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care. 2009;12(3):223-6.

8. Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2003;89(6):1028-30.

9. McMillan DC. An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer. Proc Nutr Soc. 2008;67(3):257-62.

10. Alberici Pastore C, Paiva Orlandi S, González MC. Association between an inflammatory-nutritional index and nutritional status in cancer patients. Nutr Hosp. 2013;28(1):188-93.

11. Pastore CA, Orlandi SP, Gonzalez MC. The InflammatoryNutritional Index; assessing nutritional status and prognosis in gastrointestinal and lung cancer patients. Nutr Hosp. 2014;29(3):629-34.

12. Maurício SF, Silva JB, Bering T, Correia MI. Relationship between nutritional status and the Glasgow Prognostic Score in patients with colorectal cancer. Nutrition. 2013;29(4):625-9.

13. Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutricional status? JPEN J Parenter Enteral Nutr. 1987;11(1):8-13.

14. Watt DG, Roxburgh CS, White M, Chan JZ, Horgan PG, McMillan DC. A Survey of Attitudes to wards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer. Mediators Inflamm. 2015;2015:842070.

15. Trinchieri G. Cancer and inflammation: an old intuition with rapidly evolving new concepts. Annu Rev Immunol. 2012;30:677-706.

16. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448-54.

17. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.

18. Costa MD, Vieira de Melo CY, Amorim AC, Cipriano Torres Santos AC. Association between nutritional status, inflammatory condition, and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal neoplasia. Nutr Cancer. 2016;68(7):1108-14.

19. McMillan DC.The systemic inflammation-based Glasgow prognostic score: a decade of experience in patients with cancer. Cancer Treat Rev. 2013;39(5):534-40.

20. Richards CH, Roxburgh CS, MacMillan MT, Isswiasi S, Robertson EG, Guthrie GK, et al. The relationships between body composition and the systemic inflammatory response in patients with primary operable colorectal cancer. PLoS One. 2012;7(8):e41883.

21. Lealdini V, Trufelli DC, Silva FB, Normando SR, Camargo EW, Matos LL, et al. Applicability of modified Glasgow prognostic score in the assessment of elderly patients with cancer: A pilot study. J Geriatr Oncol. 2015;6(6):479-83.

22. Tan CS, Read JA, Phan VH, Beale PJ, Peat JK, Clarke SJ. The relationship between nutritional status, inflammatory markers and survival in patients with advanced cancer: a prospective cohort study. Support Care Cancer. 2015;23(2):385-91.

23. Douglas E, McMillan DC. Towards a simple objective frame work for the investigation and treatment of cancer cachexia: the Glasgow Prognostic Score. Cancer Treat Rev. 2014;40(6):685-91.

24. Silva JB. Relação entre avaliação nutricional e escore prognóstico de Glasgow em pacientes com câncer de esôfago e estômago [Dissertação]. Belo Horizonte: Universidade Federal de Minas Gerais; 2011.

25. Ryan AM, Power DG, Daly L, Cushen SJ, Ní Bhuachalla Ē, Prado CM. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc. 2016;75(2):199-211.


Submetido em:
19/02/2017

Aceito em:
27/04/2017

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