Frequência de desnutrição em pacientes hospitalizados com insuficiência cardíaca e sua associação com desfechos clínicos no sistema único de saúde e na rede suplementar de saúde

Abstract

Introduction: Malnutrition in heart failure (HF) is a frequent and neglected problem that is associated with worse prognosis and higher costs. Objective: to evaluate the frequency of malnutrition in hospitalized patients with heart failure and its association with clinical outcomes in the Unified Health System (SUS) and Supplementary Health Network (RSS). Methodology: Cross-sectional study with 247 patients hospitalized with HF in four cardiology reference hospitals in Aracaju, Sergipe (3 referenced by SUS and 1 by RSS). Clinical, socioeconomic, health history, outcomes of discharge and after discharge (up to 30 days) were obtained. The risk of malnutrition was assessed by nutritional risk screening (NRS-2002) and malnutrition based on subjective global nutritional assessment (ASG) and nutritional mini-assessment (MAN). Weight and height were measured to calculate BMI, which was classified according to the Ministry of Health. For all statistical analyses, the significance level lower than 5% (p < 0.05) was considered. Results: Most of the sample (72.5%) was composed of SUS users. The risk of malnutrition was observed in 69.2% (NRS-2002) and malnutrition in 75.3% (ASG and MAN) (SUS = 74.9%; RSS = 76.5%; p = 0.793). of the care plan, hospital stay (> 14 days) was higher among malnourished people than those nourished (p = 0.020). The malnourished in the public system presented higher mortality (7.5%; 5.8%; p < 0.001) and hospital transfer rate (21.1%; 0.0%; p < 0.001). The frequency of readmission or urgency after discharge was observed in 23.4% of sus patients and in 21.3% of RSS (p = 0.039). Conclusion: The frequency of malnutrition was high in both systems and is associated with longer hospital stay and, in the public hospital, in-hospital death and transfers.