Triagem nutricional STRONGkids e escores PIM 2 e RACHS-1 em pacientes com cardiopatia congênita em terapia intensiva

Abstract

Introduction: Patients with congenital heart disease are considered part of a group of high nutritional risk. An adequate nutritional screening and an assessment of the severity of the clinical condition help in the treatment. The aim of this study was to evaluate the relationship between nutritional screening Screening Tool for Risk On Nutritional Status and Growth (STRONGkids) and Pediatric Index of Mortality 2 (PIM 2) and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores in patients with congenital heart disease. Methods: Cross-sectional study carried out with cardiac patients admitted to a Pediatric Intensive Care Unit from July 2017 to March 2018. An anthropometric evaluation was performed, using the STRONGkids tool and the results of the PIM 2 and RACHS-1 scores were collected. Results: 103 patients were included. According to the WHO/2006 classification, 35% (n = 36) of the patients were thin or markedly thin. According to the nutritional risk, established by the STRONGkids protocol, 50.5% (n = 52) of the patients were at high risk and no patient was considered to be of low nutritional risk. The results of the scores were considered low, PIM 2 with an average of 2.9% and 43% (n = 40) of the patients in classification 2 in the RACHS-1 score. There was a significant association between the nutritional status classified by WHO/2006 with the STRONGkids tool (p <0.001). The association of the STRONGkids tool with the PIM 2 and RACHS-1 scores was not significant (p = 0.357 and p = 0.404, respectively). Patients classified as high nutritional risk by STRONGkids stayed more days in the intensive care unit (p <0.05) and used mechanical ventilation (p <0.05). Conclusions: Although there was a significant association between the nutritional status classified by WHO/2006 with the STRONGkids tool, no association was identified between it and the risk of mortality and surgical risk through the PIM 2 and RACHS-1 scores. Nevertheless, each one of those tools could complement the nutritional assessment of patients, contributing to therapeutic interventions and the outcome in PICUs.