Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: secondary analysis of a prospective randomised trial

Hersberger, Lara; Bargetzi, Laura; Bargetzi, Annika; Tribolet, Pascal; Fehr, Rebecca; Baechli, Valerie; Geiser, Martina; Deiss, Manuela; Gomes, Filomena; Kutz, Alexander; Kaegi-Braun, Nina; Hoess, Claus; Pavlíček, V.; Schmid, Sonja; Bilz, Stefan; Sigrist, Sarah; Brändle, Michael; Benz, Carmen; Henzen, Christoph; Nigg, Melina; Thomann, Robert V.; Brand, Claudia; Rutishauser, Jonas; Aujesky, Drahomir; Rodondi, Nicolas; Donzé, Jacques; Stanga, Zeno; Müeller, Beat; Schuetz, Philipp

doi:10.1016/j.clnu.2019.11.041

Cited by 110 publications

(103 citation statements)

References 46 publications

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“…This may be related to the evaluation criteria of this instrument, which include changes in body weight and appetite (reduction of food consumption) as important factors. Several previous studies have also reported on the predictive validity of nutritional screening instruments for various clinical outcomes [ 88 , 89 , 90 , 91 ].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

et al. 2020

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Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.

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Section: Discussionmentioning

confidence: 99%

Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

et al. 2020

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“…Body height (cm), weight (kg), calf and mid-arm circumference (cm) were measured using standard methods. Results of anthropometric measures and the geriatric assessment were dichotomized at following cut-off points: Body mass index (BMI) <22 kg/m 2 for persons ≥70 years old and <20 kg/m 2 for persons <70 years old (low BMI) [19]; calf circumference <31 cm (low calf circumference) [9]; mid-arm circumference (MAC) <26.5 cm for men and <24.5 cm for women ≥75 years old, and <27.5 cm for men and <25.5 cm for women <75 years old (low MAC) [20]; mini mental state exam (MMSE) <27 points (cognitive impairment) [21]; nutritional risk screening (NRS 2002) ≥3 points (at risk of malnutrition) [22,23]; timed up and go test (TUG) ≥20 s (low physical performance) [24]. Patients who were not able to perform the TUG at admission were scored as mobility impaired.…”

Section: Geriatric Baseline Examinationmentioning

confidence: 99%

Sarcopenia in hospitalized geriatric patients: insights into prevalence and associated parameters using new EWGSOP2 guidelines

et al. 2020

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Background Data on prevalence of sarcopenia and its associated parameters in hospitalized geriatric patients are heterogeneous due to various definitions of the disease. The aim of this study was to determine the prevalence of sarcopenia using latest recommendations of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and to investigate associated parameters in patients admitted to acute geriatrics and geriatric rehabilitation. Methods In this cross-sectional single-centre study including 305 hospitalized geriatric patients, handgrip strength (pneumatic hand dynamometer) and muscle quantity (body impedance analysis) were assessed. Probable sarcopenia was defined by low handgrip strength, and the diagnosis was confirmed when both handgrip strength and muscle quantity were below cut-off points. Furthermore, parameters of the geriatric baseline examination were analyzed for association with probable and confirmed sarcopenia using logistic regression models. Results Median age of the study population was 84.0 years, and 65.6% were female. The prevalence of probable sarcopenia was 24.6% (CI 19.8–29.4%), and the prevalence of confirmed sarcopenia was 22.6% (CI 17.9–27.3%). Low calf circumference, low body mass index, cognitive impairment and an increased risk of malnutrition were found to be associated with confirmed sarcopenia. In contrast, only cognitive impairment was positively associated with probable sarcopenia. Conclusions Sarcopenia is highly prevalent in geriatric inpatients, and multiple parameters were found to be associated with the disease. To reduce negative clinical outcomes, our findings support the need for routinely performed admission examinations for prompt diagnosis of sarcopenia, and a timely start of treatment in hospitalized geriatric patients.

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Section: Discussionmentioning

confidence: 99%

Nutritional Risk Screening Tools for Elderly Patients with COVID-19: A Systematic Review

Silva¹,

Lima²,

Sena-Evangelista³

et al. 2020

Preprint

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Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in elderly people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), MNA-short form (MNA-sf), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Index (NRI), Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in elderly COVID-19 patients.

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Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: secondary analysis of a prospective randomised trial

Abstract: Nutritional risk screening (NRS 2002) is a strong and modifiable predictor risk score for short-term and long-term clinical outcomes: Secondary analysis of a prospective randomised trial, Clinical Nutrition,

Cited by 110 publications

References 46 publications

Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

Sarcopenia in hospitalized geriatric patients: insights into prevalence and associated parameters using new EWGSOP2 guidelines

Nutritional Risk Screening Tools for Elderly Patients with COVID-19: A Systematic Review

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