Rev Med UAS
Vol. 11: No. 3. Julio-Septiembre 2021
ISSN 2007-8013

1. Residente de Medicina Interna. Hospital Civil de Culiacán.
2. Médico pasante de servicio social. Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS). Uni-versidad Autónoma de Sinaloa.
3. Departamento de Nefrología y Medicina Interna. Hospital Civil de Culiacán.
4. Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS). Universidad Autónoma de Sinaloa.

*Autor de correspondencia: Edgar Dehesa-López
edgar.dehesa@gmail.com
Hospital Civil de Culiacán.
Álvaro Obregón. Culiacán, Sin. CP 80030. Tel: (667) 73032708

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v11.n3.003

Recibido 12 de Marzo 2021, aceptado 28 de Mayo 2021

RESUMEN
Objetivo: Determinar el desempeño diagnóstico de la Fuerza de Presión Palmar (FPP) para identificar Desnutrición Asociada a la Enfermedad (DAE) en pacientes hospitalizados. --- Material y métodos: Estudio transversal. Se estudiaron 86 pacientes adultos (68.6% hombres) hospitalizados con edad promedio de 59 ± 18 años. A su ingreso se evaluó el riesgo de desnutrición con el cuestionario NRS2002, se les midió la impedancia bioeléctrica y la FPP en la mano dominante. Se obtuvo sensibilidad, especificidad, Valor Predictivo Positivo (VPP), Valor Predictivo Negativo (VPN) y exactitud de la FPP para el diagnóstico de DAE mediante tablas de contingencia, utilizando como estándar de oro el Vector de Impedancia Bioeléctrica (VIBE). --- Resultados: De acuerdo al VIBE, a su ingreso el 24.4% (n=21) contaba con diagnóstico de DAE. Se comparó la composición corporal evaluada por bioimpedancia entre los pacientes con y sin desnutrición, obteniendo que los pacientes desnutridos presentaron menor Índice de Masa Libre de Grasa (IMLG) (15.9±2.2 vs 20.3±2.7; p=<0.01), Kg/músculo (42.63±6.70 vs 57.46±42.63; p= <0.01) e IMC (21.7±5.7 vs 27.6±5.5; p= <0.01). Considerando el estado nutricional, la FPP fue menor en los pacientes con DAE (14.9 ±9.6 vs 21.6 ±10.3; p=0.01). En la revisión para la FPP se obtuvo en el percentil 50 (p50): sensibilidad 100%, especificidad 21%, VPP 25%, VPN 100% y exactitud del 26.7. --- Conclusiones: La FPP puede ser una herramienta accesible, no invasiva, barata y de fácil aplicación como tamizaje de DAE en pacientes hospitalizados.
Palabras clave: Desnutrición, prensión palmar, bioimpedancia.

ABSTRACT
Objective: To determine the diagnostic performance of the Hand Strength (HS) for the diagnosis of Disease-Related Malnutrition (DAM) in hospitalized patients. --- Material and methods: Cross-sectional study. We studied 86 adult patients (68.6% male) hospitalized with an average age of 59 ± 18 years. At the admission, the risk of malnutrition was evaluated with the NRS2002 questionnaire, we measured the bioelectrical impedance and the HS in the dominant hand. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy of the HS for the diagnosis of DAM were calculated with contingency tables, using the bioelectric impedance vector as the gold standard for the diagnosis of DAM. --- Results: According to VIBE, 24.4% (n = 21) had a diagnosis of DAM at admission. The body composition evaluated by bioimpedance between patients with and without malnutrition, evidenced that the malnourished patients had lower Fat-Free Body Index (FFBI) (15.9 ± 2.2 vs. 20.3±2.7; p = <0.01), Kg / muscle (42.63±6.70 vs 57.46±42.63; p = <0.01) and Body Mass Index (BMI) (21.7±5.7 vs. 27.6±5.5; p = <0.01) compared to patients without malnutrition. According to nutritional status, HGS was lower in patients with DAM (14.9 ± 9.6 vs. 21.6 ± 10.3; p = 0.01). --- The results for the 50th percentile (p50) of the HS was: 100% sensitivity, 21% specificity, 25% PPV, 100% NPV and 26.7% accuracy. --- Conclusions: HGS can be an accessible, non-invasive, inexpensive and easily applied tool for screening DAM in hospitalized patients.
Keywords: Malnutrition, Hand strength, Bioimpedance.

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