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Nutritional assessment in patients with squamous cell carcinoma of the esophagus
Authors:Gurski Richard R  Schirmer Carlos C  Rosa André R  Brentano Loreno
Affiliation:Department of Surgery and Medical Post-Graduate Course, Faculty of Medicine, Federal University of Rio Grande do Sul, Clinicas Hospital of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. richard@portoweb.com.br
Abstract:BACKGROUND/AIMS: Protein-calorie malnutrition that occurs in patients with squamous cell carcinoma of the esophagus presents defined implications in surgical results. The present study aims to establish a nutritional score for malnutrition to measure the prevalence of protein-calorie malnutrition and to determine parameters with higher discriminatory power for protein-calorie malnutrition diagnosis. METHODOLOGY: Forty-five (45) patients with squamous cell carcinoma of the esophagus (cases) and 90 surgical patients (controls) were analyzed using twelve parameters: percentage of body weight loss, triceps and subscapular skin fold, mid arm circumference and arm muscle circumference, serum total proteins, albumin, transferin, pre-albumin, hematocrit, total lymphocyte count and late hypersensitivity skin tests. Prognostic Nutritional Index was calculated for all patients. RESULTS: There was a statistically significant difference between the two groups (p < 0.05) regarding all evaluated parameters except late hypersensitivity skin tests. Patients were classified as malnourished when presented with six or more altered parameters. Through the proposed score, the prevalence of protein-calorie malnutrition was defined in cases (57.8%) and in controls (7.8%) groups with statistic significant difference (p = 0.001). CONCLUSIONS: The proposed score allowed the diagnosis of malnourished patients, defined the malnutrition prevalence in both groups and established parameters with a greater discriminatory power for the protein-calorie malnutrition diagnosis.
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