Prevalência da desnutrição em hospitais públicos de grande porte em Manaus - AM

Abstract

It is known that the prevalence of malnutrition increases complications in hospitalized individuals, increases mortality and prolongs the stay in hospital. This study aimed to determine the prevalence of malnutrition among hospitalized individuals in public hospitals of Manaus; check the risk factors associated with malnutrition; identify the frequency of malnutrition diseases, age groups and socioeconomic levels; and assess the independent effect of hospital stay in the state of hospital malnutrition, using a cross-sectional design. For this study, we evaluated the nutritional status of 397 patients at least 18 years old, admitted to public hospitals in Manaus that had operating capacity of over 150 beds, they were: Hospital and PS Dr. João Lúcio P. Machado, Hospital and PS Dr. Aristóteles Platão Bezerra de Araújo and Hospital PS 28 de Agosto. Nutritional diagnosis was obtained by Subjective Global Assessment and anthropometric variables. The information about the nutritional therapy and hospital stay were found in the medical records. Obstetric patients, individuals unable to respond to the questionnaire and those who did not agree to participate in the study, were excluded from the sample. Data were tabulated on Epi Info 7.0 and hereby were performed frequency analysis and association between exposure and outcome of categorical variables. The risk was measured by calculating the odds ratio (OR) in order to quantify the strength of association between nutritional status and the analyzed variables. Multivariate logistic regression analysis was performed in order to control confounding variables that could interfere in the association between the risk factors studied and malnutrition. The results showed a high prevalence of malnutrition (35,26%) in hospitals, especially among patients hospitalized for neurological disorders (20%) and gastrointestinal (19,29%). Among the risk factors associated with hospital malnutrition, long hospitalization showed an association (OR = 2,97, 95% CI 1,93 to 4,57; p = 0.0000), as well as most of the analyzed covariates. However, in the final logistic regression modeling to test the independent effect of the covariates of interest, persistent changes in diet (over 30 days) and gastrointestinal symptoms, showed a greater association (OR = 33,4; CI: 12,5 to 92,55, p = 0.0000; OR = 13,28; CI: 3,86 to 45,68, p = 0.0000) with malnutrition in hospitalized, respectively. It concludes that the high prevalence of malnutrition is a reality among the evaluated patients in the hospitals of Manaus following the national and the world panorama. The analyzes suggest that two important variables must be monitored more closely, they are: persistent changes in diet and the presence of gastrointestinal symptoms. The framework presented in this study indicates the need for more effective performance of nutritional monitoring programs seeking to improve the nutritional status of hospitalized individuals