Comparação entre os Critérios GLIM, o Consenso de Caquexia do Câncer e a ASG-PPP VR para o Diagnóstico Nutricional de Pacientes com Câncer Avançado em Cuidados Paliativos
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n4.4771Palavras-chave:
Avaliação Nutricional, Desnutrição/diagnóstico, Caquexia/diagnóstico, Neoplasia/dietoterapia, Cuidados PaliativosResumo
Introdução: O diagnóstico nutricional de pacientes com câncer pode variar de acordo com o método utilizado para avaliação. Objetivo: Avaliar a concordância dos critérios do Global Leadership Initiative on Malnutrition (GLIM) e do consenso de caquexia do câncer com avaliação subjetiva global produzida pelo paciente versão reduzida (ASG-PPP VR) para diagnóstico nutricional de pacientes com câncer avançado em cuidados paliativos. Método: Estudo observacional com pacientes com câncer avançado, avaliados no primeiro atendimento em unidade de cuidados paliativos. O estado nutricional foi definido por meio do critério GLIM, do consenso de caquexia e da ASG-PPP VR. Foram analisados os valores de concordância pelo coeficiente de Kappa (k) e calculadas as medidas de acurácia entre os métodos. Resultados: Foram incluídos 254 pacientes, com mediana de idade de 65 anos e predominância do sexo masculino (55,1%). A prevalência de alterações do estado nutricional foi de 71,3%, 79,1% e 58,3%, conforme o GLIM, consenso de caquexia e ASG-PPP VR, respectivamente. A concordância entre o GLIM e o consenso de caquexia foi moderada (k = 0,79; p < 0,001), enquanto com a ASG-PPP VR foi muito fraca (GLIM k = 0,06; p = 0,320 e consenso de caquexia k = 0,06; p = 0,224). A acurácia entre o GLIM e o consenso de caquexia foi alta (92,1%), contudo, demonstraram baixa acurácia (<57,9%) em relação à ASG-PPP VR. Conclusão: Comparados com ASG-PPP VR, os critérios do GLIM e do consenso de caquexia apresentaram concordância e acurácia consideradas não aceitáveis para o diagnóstico nutricional, o que sugere menor aplicabilidade prática para a avaliação nutricional dessa população.
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Qin L, Tian Q, Zhu W, et al. The Validity of the GLIM criteria for malnutrition in hospitalized patients with gastric cancer. Nutr Cancer. 2021;73(11-12):2732-9. doi: https://doi.org/10.1080/01635581.2020.1856894 DOI: https://doi.org/10.1080/01635581.2020.1856894
Henriksen C, Paur I, Pedersen A, et al. Agreement between GLIM and PG-SGA for diagnosis of malnutrition depends on the screening tool used in GLIM. Clin Nutr. 2022;41(2):329-36. doi: https://doi.org/10.1016/j.clnu.2021.12.024 DOI: https://doi.org/10.1016/j.clnu.2021.12.024
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