Adductor pollicis muscle thickness in the nutritional assessment of hospitalized patients
Abstract
Introduction: The Thickness of the Adductor Pollicis Muscle (TAPM) has been suggested as a promising measure in the diagnosis of malnutrition in several clinical conditions. Objective: To evaluate the applicability of the TAPM and correlate it with other methods of nutritional assessment in hospitalized patients. Materials and Methods: Cross-sectional study, conducted in March 2020, with adult and elderly patients admitted to a public hospital in Jequié-Bahia. Patients were submitted to nutritional status assessment through Subjective Global Assessment (SGA) and anthropometric measurements. The TAPM was measured in both hands. Statistical analyzes were performed in SPSS® considering statistically significant values of p <0.05. Results: 15 patients with a mean age of 65.2 ± 16.3 years were evaluated. The most frequent reason for hospitalization was injuries and wounds (33.3%). The average hospital stay was 15.7 ± 11.0 days and 40% of the patients were bedridden. As for the nutritional assessment, it was observed that 53.3% of the patients were malnourished by the Body Mass Index, a result superior to that of the SGA (40%). As for the TAPM of the non-dominant hand, all patients were malnourished. There was a positive correlation between the TAPM of the non-dominant hand with weight, muscle circumference of the arm and calf circumference, and a negative correlation with the SGA. The TAPM of the dominant hand did not correlate with the other variables analyzed. Conclusion: The TAPM correlated with measures of the muscular compartment and with the SGA, reinforcing its inclusion in the nutritional assessment process in hospitalized patients.
References
-Andrade, P.A.; Santos, C.A.; Firmino, H.H.; Rosa, C. O. B. The importance of dysphagia screening and nutritional assessment in hospitalized patients. Einstein. Vol. 16. Num. 2. 2018. p.1-6.
-Blackburn, G.L.; Thornton, P.A. Nutritional assessment of the hospitalized patient. Med Clin North Am. Vol. 63. Num. 5. 1979. p. 1103-15.
-Bragagnolo, R.; Caporossi, F.S.; Dock-Nascimento, D.B.; Aguilar-Nascimento, J.E. Espessura do músculo adutor do polegar: Um método rápido e confiável na avaliação nutricional de pacientes cirúrgicos. Rev Col Bras Cir. Vol. 36. Num. .5. 2009. p. 371-6.
-Bray, G.A.; Greenway, F.L.; Molitch, M.E.; Dahms, W.; Atkinson, R.; Hamilton, K. Use of anthropometric measures to assess weight loss. Am J Clin Nutr. Vol. 31. 1978. p. 769-773.
-Caporossi, F.S.; Caporossi, C.; Dock-Nascimento, D.B.; Aguilar-Nascimento, J.E. Measurement of the thickness of the adductor pollicis muscle as a predictor of outcome in critically ill patients. Nutr Hosp. Vol. 27. Num. 2. 2012. p. 490-5.
-Chumlea, W.M.C.; Guo, S.S.; Roche, A.F.; Steinbaugh, M.L. Prediction of body weight for the nonambulatory elderly from anthropometry. J Am Diet Assoc. Vol. 88. Num. 5. 1988. p.564-8.
-Chumlea, W.M.C.; Guo, S.S.; Steinbaugh, M.L. 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. Vol. 94. Num. 12. 1994. p. 1385-8.
-Cortez, A.F.; Tolentino, J.C.; Aguiar, M.R.A. Elarrat, R.M.; Passos, R.B.F. Association between adductor pollicis muscle thickness, anthropometric and immunological parameters in HIV-positive patients. Clin Nutr ESPEN. Vol. 17. 2016. p. 105-9.
-El Kik, R.M.; Dorneles, T. C.; Schwanke, C.H.A. Association between adductor pollicis muscle thickness and nutritional parameters in hospitalized elderly patients. Nutr Hosp 2018. Vol. 35. Num. 5. 2018. p. 1059-1065.
-Fragas, R.F.M.; Oliveira, M.C. Risk factors associated with malnutrition in hospitalized patients. Rev. Nutr. Vol. 29. Num. 3. 2016. p. 329-336.
-Lameu, E.B.; Gerude, M.F.; Corrêa, R.C.; Lima, K.A. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clin Fac Med São Paulo. Vol. 59. Num. 2. 2004. p. 57-62.
-Lohman, T.G.; Roche, A.F.; Martorell, R. Anthropometric standardization reference manual. Champaign. Human Kinetics. 1988.
-Margutti, M.M.K.; Pereira, L.L.; Natielen, Schuch, N.J.; Blasi, T.C.; Schwanke, C.H.A. Espessura do músculo adutor do polegar e estado nutricional em idosos hospitalizados. Perspectiva. Vol. 41. Num. 153. 2017. p. 43-52.
-Melo, C.Y.S.V.; Silva, S.A. Músculo adutor do polegar como preditor de desnutrição em pacientes cirúrgicos. ABDC Arq Bras Cir Dig. Vol. 27. Num. 1. 2014. p. 13-7.
-OPAS. Organización Panamericana de la Salud. División de Promoción y Protección de la Salud (HPP). Encuesta Multicentrica salud beinestar y envejecimiento (SABE) em América Latina el Caribe: Informe Preliminar [Internet]. In: XXXVI Reunión del Comité asesor de investigaciones em Salud. 9-11 jun 2001. Kingston. Jamaica. OPAS. 2002.
-Pereira, P.M.L.; Neves, F.S.; Bastos, M.G. Cândido, A.P.C. Adductor Pollicis Muscle Thickness for nutritional assessment: a systematic review. Rev Bras Enferm. Vol. 71. Num. 6. 2018. p. 3093-3102.
-Pereira, P.M.L.; Soares, I.T.; Bastos, M.G.; Cândido, A.P.C. Espessura do músculo adutor do polegar utilizada na avaliação nutricional de pacientes renais crônicos em tratamento conservador. J. Bras. Nefrol. Vol. 41. Num. 1. 2019. p. 65-73.
-Rosa, C.; Silva, B.P.; Balbino, K.P.; Ribeiro, S.M.R.; Ribeiro, A.Q.; Firmino, H.H. Avaliação nutricional de indivíduos internados em um hospital geral. Mundo da Saúde. Vol. 38. Num. 4. 2014. p. 430-8.
-Souza, I.N.; Oliveira, T.M. Rodrigues, C. Espessura do músculo adutor do polegar: uso e associação com parâmetros de avaliação nutricional em pacientes de urgência e emergência. BRASPEN J. Vol. 34. Num. 1. 2019. p. 94-9.
-Toledo, D.O.; Piovacari, S.M.F.; Horie, L.M.; Matos, L.B.N.; Castro, M.G.; Ceniccola, G. Campanha “Diga não à desnutrição”: 11 passos importantes para combater a desnutrição hospitalar. BRASPEN J. Vol. 33. Núm. 1. 2018. p.86-100.
-Valente, K.P.; Silva, N.M.F.; Faioli, A.B.; Barreto, M.A.; Moraes, R.A.G.; Guandalini, V.R. Espessura do músculo adutor do polegar na avaliação nutricional de pacientes cirúrgicos. Einstein. Vol. 14. Num. 1. 2016. p. 18-24.
-Valente, K.P.; Almeida, B.L.; Lazzarini, T.R.; Souza, V.F.; Ribeiro, T.; Guedes de Moraes, R.A. Association of Adductor Pollicis Muscle Thickness and Handgrip Strength with nutritional status in cancer patients. PLoS One. Vol. 14. Num 8. 2019. p. 1-12.
-Waitzberg, D.L.; Caiaffa, W.T.; Correia, M.I. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition.Vol.17. Num.7-8. 2001. p. 573-80.
-Waitzberg, D.L.; Ferrini, M.T. Avaliação nutricional. In: Waitzberg, D. L. Nutrição enteral e parenteral na prática clínica. 2ª edição. Atheneu. 1995. p. 127-52.
-World Health Organization. Physical Status: the use and interpretation of anthropometry. Geneva, Switzerland. WHO. 1995. Technical Report Series. n. 854.
Copyright (c) 2022 Marclei Costa Barbosa, Taiane Gonçalves Novaes, Thalane Souza Santos Silva
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish in this journal agree to the following terms:
- Authors retain the copyright and grant the journal the right of first publication, with work simultaneously licensed under the Creative Commons Attribution License BY-NC which allows the sharing of the work with acknowledgment of the authorship of the work and initial publication in this journal.
- Authors are authorized to enter into additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, publishing in institutional repository or book chapter), with acknowledgment of authorship and initial publication in this journal.
- Authors are allowed and encouraged to post and distribute their work online (eg, in institutional repositories or on their personal page) at any point before or during the editorial process, as this can bring about productive change as well as increase impact and impact. citation of published work (See The Effect of Free Access).
