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Título

MINI NUTRITIONAL ASSESSMENT AS SCREENING TOOL TO DEFINE TREATMENT FOR BLADDER CANCER PATIENTS: A CROSS-SECTIONAL STUDY OF A HIGH VOLUME CENTER

Resumo

Introduction: Bladder cancer is an aggressive disease that begins in the cells lining the bladder, which grow abnormally due to mutations. The treatment of bladder cancer is complex, so a multi-professional team is necessary. One of the aggravating factors in treatment is the nutritional risk, contributing to increased morbidity and mortality. It decreases function and quality of life, increases length of hospitalization, and increases healthcare costs. In addition, bladder cancer has a higher incidence in the elderly, population at greater risk of lethality. Given this scenario, applying nutritional screening can be extremely important, since the nutritional condition can be aggravated during treatment and the progression of the disease.
Methods: The target audience were adult patients diagnosed with bladder cancer followed up at the urology outpatient clinic who answered the nutritional screening of the MAN in the short version by the medical team and later, in the nutritional consultation, answered the full version of the instrument. The data was analyzed and organized using a RedCap database. The statistical program for data analysis was SPSS, for a comparison between continuous variables, the Mann-Whitney U test and Student's t-test were. For the categorical variables, Wilcoxon Matched Pairs Test and Cohen Kappa test were used. A significance level of 5% (p≤0.05) with a confidence level of 95% was considered for all statistical tests.
Results: 46 patients were evaluated. The medical team identified 18 (39.1%) with regular nutritional status, while the nutrition team identified 13 (28.3%). When compared with the full version of the MNA applied by the nutrition team, it was noted that 32 (69.6%) patients were at nutritional risk. Individual questions of the MNA short form were also compared between both groups' application and Wilcoxon matched pairs test performed. MNA-SF may be defined as an excellent screening tool when applied by a urologist with a sensibility of 87.5% (p=0.87), and by the nutritionist with a sensibility of 93.7% (p=0.76). It is observed a raw match rate of 71.7% from both questionnaires, after Cohen Kappa test, the agreement was moderate, with 77.9% of agreement (k=0.50).
Conclusion: The application of MNA-SF has a high sensibility. However the MNA full version for nutritional screening is necessary to improve the sensibility of the assessment and guide the management of the nutritionist and the multidisciplinary team.