Navegando por Autor "Silva, Flavia Moraes"
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Artigo Is perioperative fasting associated with complications, length of hospital stay and mortality among gastric and colorectal cancer patients? A cohort study(São Paulo Medical Journal, 2020) Fayh, Ana Paula Trussardi; Virgens, Isabel Pinto Amorim das; Carvalho, Ana Lúcia Miranda de; Nagashima, Yasmim Guerreiro; Silva, Flavia MoraesBACKGROUND: During a surgical procedure, patients are often subjected to fasting for times that are more prolonged than the ideal, which may lead to complications. OBJECTIVE: To evaluate the duration of perioperative fasting and its association with postoperative complications, length of hospital stay (LOS) and mortality among gastric and colorectal cancer patients. DESIGN AND SETTING: Cohort study developed in a surgical oncology hospital in the city of Natal (Rio Grande do Norte, Brazil). METHODS: Patients aged over 18 years were included. The Clavien-Dindo surgical complication scale was used to evaluate occurrences of postoperative complications. LOS was defined as the number of days for which patients stayed in the hospital after surgery, or until the day of death. RESULTS: Seventy-seven patients participated (59.8 ± 11.8 years; 54.5% females; 70.1% with bowel tumor). The incidences of postoperative complications and death were 59.7% and 3.9%, respectively. The duration of perioperative fasting was 59.0 ± 21.4 hours, and it was higher among non-survivors and among patients with prolonged hospital stay (≥ 6 days). For each one-hour increase in the durations of perioperative and postoperative fasting, the odds of prolonged hospitalization increased by 12% (odds ratio, OR = 1.12; 95% confidence interval, CI 1.04-1.20) and 5% (OR = 1.05; 95% CI 1.02-1.08), respectively. CONCLUSION: Prolonged perioperative fasting, especially in the postoperative period, was observed in a sample of patients with gastric and colorectal cancer, and this was an independent predictor of LOSArtigo Low calf circumference is an independent predictor of mortality in cancer patients: a prospective cohort study(Nutrition, 2020-11) Fayh, Ana Paula Trussardi; Sousa, Iasmin Matias; Bielemann, Renata Moraes; Gonzalez, Maria Cristina; Rocha, Ilanna Marques Gomes da; Barbalho, Erica Roberta; Carvalho, Ana Lúcia Miranda de; Dantas, Maria Amélia Marques; Medeiros, Galtieri Otávio Cunha de; Silva, Flavia MoraesObjective: Loss of muscle mass is associated with worse outcomes in patients with cancer. The objective of this study was to evaluate the prognostic value of calf circumference (CC) and skeletal muscle index from computed tomography (CT) to predict mortality in patients with cancer. Methods: A single-center prospective study was conducted with patients aged 20 y attending a reference center of oncology and who had recent abdominal CT images. Data were collected through a semistructured form and patients’ records and included sociodemographic data (sex, age and ethnicity), clinical data (primary site and staging of tumor and treatments performed), anthropometric variables (body mass index and CC), and outcome (death). Low CC for men was considered to be 34 cm and for women 33 cm. Muscle mass was assessed by CT images at the level of L3. The Cox proportional hazard model adjusted for age, sex, and staging of disease was used. Results: A total of 250 patients were evaluated, 52.8% female, with a median age of 63 y (interquartile ratio: 5573). Normal body mass index was identified in 44.4%; 29.2% had low skeletal muscle index, and 46.4% had low CC. Death by any cause occurred in 16%, and only low CC was a significant predictor of mortality (hazard ratio = 3.01; confidence interval 1.525.98; P = 0.002). Conclusions: Low CC can predict risk of mortality in this cohort of patients. The findings suggest the use of CC as a simple, easy, cost-effective anthropometric measurement to quickly screen patients at risk of death who could benefit from targeted care to improve their prognosis