Circunferência da panturrilha e sobrevida em 6 meses em pacientes idosos com câncer
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Apr 30, 2025
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Resumo
Objetivo: Verificar se o CP baixo (<31 cm) ao diagnóstico é fator de risco independente para óbito em idosos com câncer. Métodos: Este estudo utilizou dados secundários de uma coorte de idosos com câncer internados de 2016 a 2020 no Nordeste do Brasil. Avaliação geriátrica e dados sociodemográficos, antecedentes e clínicos foram coletados na admissão. Os critérios de inclusão foram pacientes submetidos à medição de CP baseada em MAN. O desfecho primário foi morte durante o seguimento de 180 dias. As razões de risco (HR) brutas e ajustadas foram obtidas a partir do modelo de risco proporcional de Cox, e a análise de sobrevivência utilizou o método de Kaplan-Meier de acordo com CP. Resultados: Dos 414 pacientes incluídos, 32,6% apresentaram CP baixa. A taxa de mortalidade geral foi de 21,5% (89 óbitos), 25,9% para o grupo de CP baixo e 19,7% para o grupo de CP adequado. A baixa CP não foi identificada como fator de risco independente para óbito na análise bivariada e multivariada. A probabilidade de sobrevivência não foi diferente entre os pontos de corte do CP. Conclusão: A baixa MM avaliada através do ponto de corte de CP recomendado pela OMS e MAN não apresentou valor preditivo para óbito em idosos com câncer.
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Como Citar
SantosP. A. A. dos, SilvaF. R. de M., BorbaG. de M. R., SilveiraA. C. R., LimaJ. T. de O., & MelloM. J. G. de. (2025). Circunferência da panturrilha e sobrevida em 6 meses em pacientes idosos com câncer. Revista Eletrônica Acervo Saúde, 25, e19568. https://doi.org/10.25248/reas.e19568.2025
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39. SOUSA IM, et al. Prognostic Value of Isolated Sarcopenia or Malnutrition-Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients. Nutrients, 2022; 14(11): 2207.
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45. YIN L, et al. Several anthropometric measurements and cancer mortality: predictor screening, threshold determination, and joint analysis in a multicenter cohort of 12138 adults. Eur J Clin Nutr., 2022; 76(5): 756–64.
2. BARBALHO ER, et al. Is skeletal muscle radiodensity able to indicate physical function impairment in older adults with gastrointestinal cancer ? Exp Gerontol. Elsevier, 2019; 125: 110688.
3. BARBOSA-SILVA TG, et al. Prevalence of sarcopenia among community-dwelling elderly of a medium-sized South American city: Results of the COMO VAI? Study. J Cachexia Sarcopenia Muscle, 2016; 7(2): 136–43.
4. CANDOW DG, CHILIBECK PD. Differences in Size , Strength , and Power of Upper and Lower Body Muscle Groups in Young and Older Men., 2005; 60(2): 148–56.
5. CASTILLO-MARTÍNEZ L, et al. Nutritional Assessment Tools for the Identification of Malnutrition and Nutritional Risk Associated with Cancer Treatment. Rev Investig Clínica, 2018; 70(3).
6. CHANG AY, et al. Measuring population ageing : an analysis of the Global Burden of Disease Study 2017. Lancet Public Heal., 2017; 4(3): 159–67.
7. CHARLSON ME, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis., 1987; 40(5): 373–83.
8. CHENG X, et al. Population ageing and mortality during 1990 – 2017 : A global decomposition analysis. Plos Med., 2020; 17(6): 1003138.
9. CHEN LK, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. Elsevier Inc.; 2020; 21(3): 300–307.
10. CHRISTNER S, et al. Evaluation of the nutritional status of older hospitalised geriatric patients: a comparative analysis of a Mini Nutritional Assessment (MNA) version and the Nutritional Risk Screening (NRS 2002). J Hum Nutr Diet., 2016; 29(6): 704–713.
11. CRAIG CL, et al. International physical activity questionnaire: 12-Country reliability and validity. Med Sci Sports Exerc., 2003; 35(8): 1381–95.
12. CRUZ-JENTOFT AJ, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019; 48(1): 16–31.
13. D’ALMEIDA CA, et al. Prevalence of Malnutrition in Older Hospitalized Cancer Patients: A Multicenter
14. DA COSTA PEREIRA JP, et al. Frailty but not low muscle quality nor sarcopenia is independently associated with mortality among previously hospitalized older adults: A prospective study. Geriatr Gerontol Int., 2023; 23(10): 736-43.
15. EDWARDS BJ, et al. Overall survival in older patients with cancer. BMJ Support Palliat Care, 2020; 10(1): 25–35.
16. FAYH APT and de SOUSA IMGM. New insights on how and where to measure muscle mass. Curr Opin Support Palliat Care, 2020; 14: 316–23.
17. GNJIDIC D, et al. Polypharmacy cutoff and outcomes : five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol., 2012; 65(9): 989–95.
18. GONZALEZ MC, et al. Calf circumference: Cutoff values from the NHANES 1999-2006. Am J Clin Nutr. Oxford University Press, 2021; 113(6): 1679–87.
19. GUIGOZ Y, et al. Assessing the Nutritional Status of the Elderly: The Mini Nutritional Assessment as Part of the Geriatric Evaluation. Nutr Rev. 2009; 54(1): 59–65.
20. ISLEYEN ZS, et al.The risk of malnutrition and its clinical implications in older patients with cancer. Aging Clin Exp Res., 2023; 35(11): 2675–83.
21. JANSSEN I, et al. Skeletal muscle mass and distribution in 468 men and women aged 18 – 88 yr. Journal of Applied Physiology, 2000; 89: 81–8.
22. JAFARINASABIAN P, et al. Aging human body: Changes in bone, muscle and body fat with consequent changes in nutrient intake. J Endocrinol., 2017; 234(1): 37–51.
23. KAISER MJ, et al. Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status. J Nutr Heal Aging, 2009; 13(9): 782–8.
24. KARNOFSKY DA, BURCHENAL J. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM (ed), Evaluation of Chemotherapeutic Agents. New York Columbia Univ Press: Elsevier Masson SAS; 1949: 191–205.
25. KÄSMANN L, et al. Karnofsky performance score, radiation dose and nodal status predict survival of elderly patients irradiated for limited-disease small-cell lung cancer. Anticancer Res., 2016; 36(8): 4177–80.
26. KAZEMI-BAJESTANI SMR, et al. Computed tomography-defined muscle and fat wasting are associated with cancer clinical outcomes. Semin Cell Dev Biol. Elsevier Ltd; 2016; 54: 2–10.
27. LANDI F, et al. Calf circumference , frailty and physical performance among older adults living in the community. Clinical Nutrition, 2014; 33: 539–44.
28. LIMA J, MORAES SILVA F. Comments on the methodology and completeness of a meta-analysis on the association between low calf circumference and mortality. Eur Geriatr Med., 2022; 13(4): 1011–2.
29. LÓPEZ-OTÍN C, et al. The Hallmarks of Aging Longevity. Cell, 2013; 153(6): 1194–217.
30. PALMELA C, et al. Body composition as a prognostic factor of neoadjuvant chemotherapy toxicity and outcome in patients with locally advanced gastric cancer. J Gastric Cancer, 2017; 17(1): 74–87.
31. PODSIADLO D, RICHARDSON S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc., 1991; 39(2): 142–8.
32. ROLLAND Y, et al. Sarcopenia, Calf Circumference, and Physical Function of Elderly Women: A Cross‐Sectional Study. J Am Geriatr Soc., 2003; 51(8): 1120–4.
33. SALES LT, et al. Nutritional risk as a predictor of short-term outcomes in a prospective cohort of elderly patients with cancer. Ann Oncol., 2017; 28: 549.
34. SILVA JR, et al. Different methods for diagnosis of sarcopenia and its association with nutritional status and survival in patients with advanced cancer in palliative care. Nutrition, 2019; 60: 48–52.
35. SODERSTROM L, ROSENBLAD A. Long-term association between malnutrition and all-cause mortality among older adults : A 10-years follow-up study. Clinical Nutrition, 2023; 42: 2554-61.
36. SOUSA IM, et al. Accuracy of isolated nutrition indicators in diagnosing malnutrition and their prognostic value to predict death in patients with gastric and colorectal cancer: A prospective study. J Parenter Enter Nutr., 2022; 46(3): 508–16.
37. SOUSA IM, et al. Low calf circumference adjusted for body mass index is associated with prolonged hospital stay. The American Journal of Clinical Nutrition, 2023; 117: 402–7.
38. SOUSA IM, et al. Low calf circumference is an independent predictor of mortality in cancer patients: a prospective cohort study. Nutrition, 2020; 79–80: 1–7.
39. SOUSA IM, et al. Prognostic Value of Isolated Sarcopenia or Malnutrition-Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients. Nutrients, 2022; 14(11): 2207.
40. TSAI AC, CHANG T. The effectiveness of BMI, calf circumference and mid-arm circumference in predicting subsequent mortality risk in elderly Taiwanese, 2011; 275–81.
41. WEI J, et al. The association between low calf circumference and mortality: a systematic review and meta-analysis. Eur Geriatr Med., 2022; 13(3): 597–609.
42. WILDIERS H, et al. International society of geriatric oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol., 2014; 32(24): 2595–603.
43. WORLD HEALTH ORGANIZATION. WHO Expert Committee on Physical Status: The Use and Interpretation of Anthropometry. Geneva; 1995. Available at: https://www.who.int/publications/i/item/9241208546.
44. WORLD HEALTH ORGANIZATION. Guidance on person-centred assessment and pathways in primary care. Handbook. 2019;88. Available at: https://www.afro.who.int/publications/handbook-guidance-person-centred-assessment-and-pathways-primary-care..
45. YIN L, et al. Several anthropometric measurements and cancer mortality: predictor screening, threshold determination, and joint analysis in a multicenter cohort of 12138 adults. Eur J Clin Nutr., 2022; 76(5): 756–64.