Evaluation of Different Screening Tools for Detection of Malnutrition in Hospitalised Patients

Overview

Journal J Clin Nurs

Specialty Nursing

Date 2024 Apr 17

PMID 38629350

Authors

Regina Cortes

Aina M Yanez

Laura Capitan-Moyano

Aina Millan-Pons

Miquel Bennasar-Veny

Affiliations

Soon will be listed here.

Abstract

Aims And Objectives: To assess the prevalence of malnutrition in hospitalised adult patients, and to evaluate the accuracy of the most commonly used nutritional screening tools for identifying individuals at risk of malnutrition.

Methods: A prospective cross-sectional study was conducted on a total of 248 hospitalised patients in internal medicine wards (mean age: 75.2 years; 39.5% females). Nutritional screening was performed within 48 h of admission using the following tools: Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening Tool (NRS-2002), Malnutrition Screening Tool (MST), Short Nutritional Assessment Questionnaire (SNAQ), and Mini Nutritional Assessment Short Form (MNA-SF). The criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were used as the gold standard for defining malnutrition. Patients were also evaluated using the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Accuracy was determined by examining sensitivity, specificity, and positive and negative predictive values, and diagnostic agreement was determined by calculation of Cohen's kappa (κ). The study is reported as per the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Results: The ESPEN criteria classified 20.2% of the hospitalised patients as malnourished. Overall, the MUST had the highest sensitivity (80.0%), specificity (74.7%) and positive predictive value (44.4%). For the subgroup of patients aged >65 years, the MNA-SF had high sensitivity (94.4%) but low specificity (39.0%). Based on Cohen's κ, the SGA and GLIM criteria showed low agreement with the ESPEN criteria.

Conclusion: The MUST was the most accurate nutritional screening tool, through the MST is more easily applied in many clinical settings. A comprehensive assessment of malnutrition that considers muscle mass is crucial for the reliable diagnosis of malnutrition.

Implications For The Profession And/or Patient Care: The present findings underscore the importance of accurate assessment of the malnutrition status of hospitalised patients and the need for a reliable screening tool. No patient or public contribution.

Citing Articles

Determinants of Malnourishment in the Institutionalized Older Population: The FRAGILESS Study.

Leira J, Maseda A, Lopez-Lopez R, Lorenzo-Lopez L, Cibeira N, Lodeiro-Fernandez L Nutrients. 2024; 16(23).

PMID: 39683508 PMC: 11643531. DOI: 10.3390/nu16234114.

Evaluation of different screening tools for detection of malnutrition in hospitalised patients.

Cortes R, Yanez A, Capitan-Moyano L, Millan-Pons A, Bennasar-Veny M J Clin Nurs. 2024; 33(12):4759-4771.

PMID: 38629350 PMC: 11579573. DOI: 10.1111/jocn.17170.

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