Aspectos nutricionais e qualidade de vida em pacientes com neoplasias hematológicas

Abstract

INTRODUCTION: In patients with hematologic malignancies, impaired nutritional status has a negative impact on disease prognosis, treatment tolerance, survival, and especially quality of life. However, there are few studies that investigate the relationship between nutritional status and quality of life in adult and elderly patients with hematologic malignancies. OBJECTIVE: To investigate a possible relationship between nutritional status and quality of life in hospitalized patients with hematologic malignancies. METHOD: Cross sectional and observational study in patients with hematologic malignancies aged ≥ 18 years, both sexes, admitted for treatment in the oncohematology wards of a University Hospital, from July 2021 to July 2022. Sociodemographic, nutritional, clinical, lifestyle and quality of life data were evaluated. Nutritional assessment was assessed using objective (anthropometry and dynamometry) and subjective (Patient-Generated Subjective Global Assessment) methods. Quality of life was assessed using the FACT-G instrument. RESULTS: A total of 100 patients were evaluated, with a mean age of 49.2 ± 16.1 years. Most were adults (70%), female (59%), with education ≤ high school (85%) and income less than two minimum wages (75%). Multiple myeloma was the most prevalent neoplasm (39%), followed by leukemia (35%) and then lymphoma (25%). A high prevalence of patients at risk of malnutrition or presence of malnutrition was found by the PG-SGA, despite having a high percentage of overweight patients evaluated by BMI. When assessing absolute handgrip strength, 25.3% of patients had reduced strength. Relative strengths by weight and BMI were also evaluated, with a mean of 0.44 and 1.14, respectively. Patients diagnosed with hematologic malignancies in general showed a negative correlation between nutritional status by PG-SGA and FACT-G scores (r= -0.45; p<0.01) and physical subdomains (r= -0.49; p<0.01 ), emotional (r= -0.29; p<0.01) and functional (r= -0.23; p<0.05). A positive correlation was observed between the HGS value and the FACT-G score (r= 0.25; p<0.05) and the physical subdomain (r= 0.29; p<0.01). Regarding relative handgrip strengths, positive correlations were found between HGS relative to weight and the physical subdomain (r= 0.25; p<0.05) and between HGS relative to BMI and the FACT-G score (r= 0.22 ; p< 0.05) and the physical subdomain (r= 0.30; p<0.01). An increase of one unit on the PG-SGA scale is significantly associated with a reduction of 0.45 points on the FACT-G scale (β = -0.45; 95%CI: -0.63; -0.27); each unit that increases in absolute HGS interferes with an increase of 0.25 points on the FACT-G scale (β = 0.25; 95%CI: 0.05; 0.45). CONCLUSION: Patients with hematological malignancies who have better nutritional status and greater muscle strength have better general, physical, emotional, social and functional quality of life scores, with emphasis on PG-SGA and handgrip strength in influencing quality of life scores. The product of this dissertation contributes to the broadening of the debate on nutritional aspects, especially with regard to handgrip strength, as an indicator of relevance for the approach to patients with hematological neoplasia, especially in the hospital environment.