Association of Nutritional Indicators and Mortality Risk in Hospitalized Patients in an Emergency Unit
DOI:
https://doi.org/10.55892/jrg.v9i20.2926Keywords:
Nutritional Risk Screening, Mortality, Critically Ill Patients, Emergency UnitAbstract
Introduction: Stabilization Rooms (SRs) are strategic units within the emergency care network, designed for the initial management of critically ill patients, who are characterized by a high prevalence of chronic diseases and nutritional risk. Hospital malnutrition is associated with worse clinical outcomes and increased mortality. Objective: To evaluate the association between nutritional risk, feeding route, and 28-day mortality in patients admitted to the emergency unit of a public general hospital in the Federal District, Brazil. Methods: This was a prospective, observational, and analytical cohort study conducted between March and September 2025, including adult patients admitted to the Red and Yellow SRs. Sociodemographic, clinical, and nutritional data were collected, including anthropometric measurements, Body Mass Index (BMI) classification, and nutritional risk screening using the Nutritional Risk Screening 2002 (NRS-2002). Patients were followed for 28 days through electronic medical records to assess clinical outcomes. Results: The sample consisted of 81 patients, predominantly male (53.1%) and aged 60 years or older (63.0%). A high prevalence of nutritional risk was observed at hospital admission (58.0%), which remained after 28 days of hospitalization (58.3%). The oral feeding route was the most frequently used both at admission and after 28 days. The 28-day mortality rate was 6.2%, with no statistically significant association between nutritional risk and mortality, nor between feeding route and mortality. Conclusion: Patients admitted to SRs showed a high prevalence of nutritional risk. Although no statistically significant association with 28-day mortality was observed, the frequency of nutritional risk among patients who progressed to death reinforces the importance of early nutritional screening in emergency units as a fundamental strategy for identifying patients at risk and guiding timely nutritional interventions.
Downloads
References
Brasil. Ministério da Saúde. Portaria nº 2.338, de 3 de outubro de 2011. Estabelece diretrizes para a organização das Salas de Estabilização no âmbito do Sistema Único de Saúde. Diário Oficial da União. 2011 out 5; Seção 1.
Secretaria de Estado de Saúde do Distrito Federal. Manual de acolhimento e classificação de risco da Rede de Atenção às Urgências do Distrito Federal. Brasília: SES-DF; 2021.
Soster CB, Vieira CS, Teixeira CC, Girardon-Perlini NMO, Tonin L, Vargas MAO. Atendimento em serviços de urgência e emergência no Brasil: desafios e perspectivas. Rev Latino-Am Enfermagem. 2022;30:e3511. doi:10.1590/1518-8345.0000.3511.
Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48–79. doi:10.1016/j.clnu.2018.08.037.
Associação Brasileira de Nutrição Parenteral e Enteral (BRASPEN). Diretriz brasileira de terapia nutricional no paciente grave. BRASPEN J. 2023;38(Supl 1):1–60.
Bossi P, Delrio P, Mascheroni A, Zanetti M, Pedrazzoli P. Nutrition and cancer: a multidisciplinary approach. Nutrients. 2021;13(6):1980. doi:10.3390/nu13061980.
Bakkaloglu OK, Ergen A, Balci C, Turan S, Yalcin M, Ozdemir C. Prevalence of malnutrition and nutritional risk in hospitalized patients: a multicenter study. Eur Rev Med Pharmacol Sci. 2023;27(12):5812–5821. doi:10.26355/eurrev_202306_32640.
Kondrup J, Rasmussen HH, Hamberg O, Stanga Z. Nutritional Risk Screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321–336. doi:10.1016/S0261-5614(02)00214-5.
Leandro-Merhi VA, Aquino JLB. Avaliação nutricional em pacientes hospitalizados: comparação entre diferentes métodos. Arq Bras Cir Dig. 2009;22(3):143–146. doi:10.1590/S0102-67202009000300003.
Maia LA, Silva DR, Lima JP, Costa TM. Impacto do início precoce da terapia nutricional em pacientes hospitalizados. Braz J Health Rev. 2021;4(5):19962–19972. doi:10.34119/bjhrv4n5-294.
Valadão TA, Bottoni A, Waitzberg DL. Terapia nutricional precoce e desfechos clínicos em pacientes hospitalizados. BRASPEN J. 2021;36(2):145–150.
World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. Geneva: World Health Organization; 1997. (WHO Technical Report Series, No. 894).
Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55–67.
Chumlea WC, Guo SS, Roche AF, Steinbaugh ML. Prediction of body weight for the nonambulatory elderly from anthropometry. J Am Geriatr Soc. 1988;36(1):37–42. doi:10.1111/j.1532-5415.1988.tb01908.x.
Saueressig C, dos Santos JG, Wolf R, Dall’Alba V. Utilização de métodos indiretos para estimativa de peso corporal e estatura e sua correlação com os valores aferidos em pacientes hospitalizados. BRASPEN Journal. 2022;37(4):340–5. doi:10.37111/braspenj.2022.37.4.03.
Chumlea WMC, Guo SS, Steinbaugh ML. Prediction of stature from knee height for black and white adults and children with application to mobility-impaired or handicapped persons. J Am Diet Assoc. 1994 Dec;94(12):1385–1391. doi:10.1016/0002-8223(94)92540-2.
Machline-Carrion MJ, Sen S, Almeida SRM, et al. Global burden of stroke: update 2025. Stroke. 2025;56(4):957–964. doi:10.1161/STROKEAHA.124.000000.
Panorama das DNTs 2025. Vigilância e monitoramento das DNTs: Mortalidade por doenças não transmissíveis e prevalência de fatores de risco associados na Região das Américas 2025.
Oliveira GMM, Brant LCC, Polanczyk CA, Biolo A, Nascimento BR, Malta DC, et al. Estatística cardiovascular – Brasil 2024. Arq Bras Cardiol. 2024;121:e20240079. doi:10.36660/abc.20240079.
Wang J, Chen X, Zhao Y, Li Z, Chen J, Shen B. Nutritional risk screening and mortality in hospitalized patients. Front Nutr. 2022;9:857841. doi:10.3389/fnut.2022.857841.
Associação Brasileira de Nutrição Parenteral e Enteral (BRASPEN). Diga não à desnutrição: diagnóstico nutricional no Brasil. São Paulo: BRASPEN; 2021.
Ghadamieh F, Matta J, Naja F, Nasrallah MP. Association between nutritional risk and mortality in hospitalized adults. Clin Nutr ESPEN. 2023;55:357–363. doi:10.1016/j.clnesp.2023.03.021.
Santos CA, Ribeiro AQ, Rosa COB, et al. Indicadores nutricionais e mortalidade hospitalar em pacientes graves. BRASPEN J. 2017;32(1):30–35.
