RESUMO
BACKGROUND: Nutrition therapy plays a major role in the perioperative management of surgical patients. Understanding energy metabolism and correctly establishing the adequate energy needs is a crucial step to provide optimal nutrition care. The aim of this study was to assess the resting energy expenditure (REE) after major abdominal procedures and its associated factors. METHODS: This was a prospective observational study conducted at a single center. REEs of patients admitted for gastrointestinal surgical procedures were measured by indirect calorimetry 24 hours prior to the procedure and reassessed at least once within the fifth postoperative day. Substrate oxidation was calculated according to the Frayn equation. Nutrition status was evaluated using subjective global assessment. RESULTS: There were no significant changes in the REEs throughout the study period; however, there was a decrease in the respiratory quotient during the postoperative period, as well as a decrease in carbohydrate oxidation and an increase in lipid oxidation. Only 33.3% of the patients presented a postoperative increase in REE > 10%. Those patients presented higher blood-monocyte levels. CONCLUSION: Postoperative REE is not increased in most of the patients. In patients who had increased REE, associated factors included higher levels of monocytes.
Assuntos
Metabolismo Energético , Descanso , Metabolismo Basal , Calorimetria Indireta , Humanos , Estado Nutricional , Período Pós-OperatórioRESUMO
OBJECTIVE: The aim of this study was to evaluate the association between preoperative nutritional status and health-related quality of life (HRQoL) in patients with gastrointestinal cancer who were admitted for elective surgical treatment. METHODS: This was a cross-sectional study in which patients with a diagnosis of gastrointestinal cancer were evaluated before a surgical procedure. The nutritional assessment included subjective global assessment (SGA) and measurements of weight loss percentage, bioelectrical impedance, and functional capacity. HRQoL was evaluated by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Statistical analyses were performed with a significance level of 5%. The sample size was calculated based on a pilot study. RESULTS: We evaluated 132 patients, the majority of whom were men. The median age of the patients was 62 y, and the most prevalent tumors were in the colon, rectum, and anus (52.3%). The SGA highlighted the high prevalence of malnutrition (69.9%), which was confirmed by the rates of weight loss (73.8%) and the low fat-free mass index (56.8%). Malnourished patients and patients with severe weight loss had worse functional, symptom, global health and quality of life scores (P < 0.05). Malnutrition, according to the SGA, decreased physical function and role performance scores by 9 and 20 points, respectively (P < 0.05). CONCLUSION: Malnutrition, assessed by various tools, was associated with poor HRQoL of surgical patients with gastrointestinal cancer.