Associação do risco nutricional com a mortalidade em 28 dias de pacientes críticos após acidente vascular encefálico

Abstract

Background: Cerebrovascular accident, one of the global mortality main causes, is associated to malnutrition due to the patients clinical conditions. Therefore, evaluating the relation between nutritional risk and clinical outcome of patients that stayed in ICU after stroke is important. Objective: Our objective is to evaluate the association between nutritional risk (NRS-2002) and 28-day mortality in stroke patients, as well as their length of hospital stay. Methods: A retrospective longitudinal and analytic study. Medical inpatient records from intensive care units of a public hospital localized in Brasilia, were analyzed from 2014 to 2017. Data was collected using electronic medical record and occurred from June to December 2018. Results: After the analysis, 137 patients were included in this research. Study population consisted of 49,6% male individuals and 50,4% female individuals. Nutritional risk was detected in 91.2% of the sample. Groups (based on nutritionally ‘at-risk’ and “no risk’ patients) were analyzed separately. Individuals without nutritional risk had a median age of 48 years (IQR 42.5-53.5) and individuals with nutritional risk had a median age of 55 years (IQR 33-77). In the multivariate analysis, the nutritionally 'at-risk' group presented higher probability for 28-day mortality (OR 1.518; I.C. 95% 1.045 – 2.206) with statistically significant value (p=0.029). Time between ictus and ICU admission demonstrated an association with 28-day mortality (OR 0.881; I.C. 95% 0.802 – 0.967), in which patients that arrived at ICU quicker presented survival factor (P=0.008). Conclusion: Nutritional risk is associated with mortality and length of ICU stay. Furthermore, patients that delay to arrive at ICU present higher odds ratio for death.