The evaluation of an undernutrition risk score to be used by nursing staff in a teaching hospital to identify surgical patients at risk of malnutrition on admission: a pilot study

Abstract

CorrespondenceMargaret Doyle,Background The purpose of this study was to evaluate an undernutrition risk score (URS) developed by the Dietetic Department of an acute tertiary referral hospital in Dublin with the aim that the URS could be used by nursing staff, to identify surgical patients at risk of malnutrition on admission.Methods Forty surgical patients (16 males and 24 females) were recruited, within 5 days of admission. A standard objective nutritional assessment was carried out on each patient. This consisted of a 3-day diet history, anthropometric indices including: weight, armspan, midupper arm circumference, mid-arm muscle circumference and hand grip dynamometry. A nutrition risk index (NRI) screening tool was also used by a single observer to categorize patients as having low, moderate or severe risk of malnutrition. The indices used for the NRI were serum albumin and percentage weight loss. The URS assessed patients with respect to changes in weight and appetite, gut function and disease status and was completed by nursing staff by interview for each of the patients recruited. ResultsThe URS was successful in detecting 71.4% (n = 10) of surgical patients who were classified as being at some risk (moderate/ severe) for undernutrition by the NRI. However, 11.8% (n = 4) of the patients who were categorized by the NRI as being at moderate risk for undernutrition were classified as being at low risk by the nursing staff using the URS. The URS was found to be most sensitive in the detection of those at low or severe risk for undernutrition and least sensitive for those at moderate risk. ConclusionThe undernutrition risk score in this study provided an accurate and consequently useful screening tool that could be used for surgical patients who are capable of feeding themselves independently.

Clinical significance of nutritional risk screening for older adult patients with COVID-19

“…In this study, NRS 2002, MNA-sf, and NRI showed good performance in predicting worse-than-average clinical outcomes, but MUST did not. The correlation between MUST and changes in BMI, appetite, and weight may be related to its focus points of BMI, unintentional weight loss, and whether the patient is in an acute disease state [7], while the other screening tools also account for factors, such as mobility and mental state of patients in MNA-sf, and ALB in both NRS 2002 and NRI [5,6,8]. According to MUST criteria, if the patient was in an acute disease state, the patient was rated two points.…”

“…NRI was calculated by a simple equation that uses serum albumin and recent body weight loss. Nutritional Risk Index = (1.519 × serum albumin, g/L) + 0.417 × (present weight/usual weight × 100) [8].…”

“…While some malnourishment stems from underlying illness, much is due simply to inadequate intake, which should be reversible if detected. Nutrition Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), Mini Nutrition Assessment Shortcut (MNA-sf), and Nutrition Risk Index (NRI) are currently commonly used clinical nutrition screening methods [5][6][7][8]. Previous studies have validated the role of these non-disease-specific nutritional risk screening (NRS) tools to identify nutritional risks in hospitalized patients with multiple diseases [9,10].…”

Evaluation of malnutrition in hospitalised patients in Greece

“…Undernutrition risk score (URS) (2) and nutritional risk screening (NRS-2002) (3) were simultaneously used for the nutrition screening of seventy-one patients in a pathology clinic (age 49 (SD 17) years, BMI 25.7 (SD 4.8) kg/m 2 ) and thirty-one patients in an orthopaedic clinic (age 50 (SD 20) years, BMI 26 (SD 5.2) kg/m 2 ) of Papageorgiou Hospital (Thessaloniki, Greece).…”

Adaptação transcultural e avaliação das propriedades psicométricas do Determine Your Nutritional Health®, para idosos, no município de São Paulo - SP, Brasil

“…Eles também devem contemplar valores de confiabilidade, de validade, de sensibilidade e de especificidade, antes da sua utilização na prática clínica ou em estudos epidemiológicos 32,34 . 46 , constituindo aqueles mais utilizados no mundo, inclusive no Brasil 32,34,40 .…”