Triagem Nutripal Adaptada e Sobrevida Global em Pacientes com Câncer em Cuidados Paliativos

Maria da Paixão Rodrigues; Aline do Vale Firmino; Thais Manfrinato Miola

doi:10.32635/2176-9745.RBC.2026v72n2.5648

Autores/as

Maria da Paixão Rodrigues A. C. Camargo Cancer Center. São Paulo (SP), Brasil. https://orcid.org/0000-0003-2351-7857
Aline do Vale Firmino A. C. Camargo Cancer Center. São Paulo (SP), Brasil. https://orcid.org/0000-0002-4016-5497
Thais Manfrinato Miola A.C.Camargo Cancer Center https://orcid.org/0000-0002-6554-6923

DOI:

https://doi.org/10.32635/2176-9745.RBC.2026v72n2.5648

Palabras clave:

Evaluación Nutricional, Cribado, Cuidados Paliativos, Análisis de Supervivencia, Pronóstico

Resumen

Introducción: El riesgo nutricional es frecuente en pacientes con cáncer en cuidados paliativos y está asociado con una menor esperanza de vida. El tamizaje Nutripal es una herramienta específica para esta población, que integra la valoración global subjetiva generada por el paciente (VGS-GP) y el puntaje pronóstico de Glasgow (GPS). Objetivo: Analizar la aplicabilidad de una versión adaptada de Nutripal, sin el uso de albúmina, y verificar su asociación con la supervivencia global. Método: Estudio de cohorte retrospectiva, realizado en un Cancer Center entre julio de 2023 y julio de 2024, que incluyó pacientes en cuidados paliativos. El tamizaje Nutripal se aplicó en su versión completa (grados 1 a 4) y en su versión adaptada (grados 1 a 3). El desenlace primario fue analizar la supervivencia global a 180 días. Resultados: Se incluyeron 200 pacientes, la mayoría con riesgo nutricional (79%) y diagnóstico de desnutrición grave (76%). Puntuaciones 9 o más en la VGS-GP no se asociaron con la mortalidad. Los pacientes clasificados en el mayor grado de riesgo, tanto en la versión completa como en la adaptada de Nutripal, presentaron mayor riesgo de mortalidad a 180 días (p=0,02; HR = 1,57; IC 95%: 1,04–2,36), independientemente de la edad, diagnóstico oncológico y resultados de la Palliative Performance Scale (PPS), con discriminación moderada y similar entre las versiones (estadístico C igual a 0,651 en la versión completa y 0,637 en la adaptada). Conclusión: El tamizaje Nutripal adaptado demostró ser aplicable para la identificación del riesgo nutricional, con capacidad para predecir una menor supervivencia global.

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