Stratton Rebecca J, Hackston Annemarie, Longmore David, Dixon Rod, Price Sarah, Stroud Mike, King Claire, Elia Marinos
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, UK.
Br J Nutr. 2004 Nov;92(5):799-808. doi: 10.1079/bjn20041258.
The 'malnutrition universal screening tool' ('MUST') for adults has been developed for all health care settings and patient groups, but ease of use and agreement with other published tools when screening to identify malnutrition requires investigation. The present study assessed the agreement and the prevalence of malnutrition risk between 'MUST' and a variety of other tools in the same patients and compared the ease of using these tools. Groups of patients were consecutively screened using 'MUST' and: (1) MEREC Bulletin (MEREC) and Hickson and Hill (HH) tools (fifty gastroenterology outpatients); (2) nutrition risk score (NRS) and malnutrition screening tool (MST; seventy-five medical inpatients); (3) short-form mini nutritional assessment (MNA-tool; eighty-six elderly and eighty-five surgical inpatients); (4) subjective global assessment (SGA; fifty medical inpatients); (5) Doyle undernutrition risk score (URS; fifty-two surgical inpatients). Using 'MUST', the prevalence of malnutrition risk ranged from 19-60% in inpatients and 30% in outpatients. 'MUST' had 'excellent' agreement (kappa 0.775-0.893) with MEREC, NRS and SGA tools, 'fair-good' agreement (kappa 0.551-0.711) with HH, MST and MNA-tool tools and 'poor' agreement with the URS tool (kappa 0.255). When categorisation of malnutrition risk differed between tools, it did not do so systematically, except between 'MUST' and MNA-tool (P=0.0005) and URS (P=0.039). 'MUST' and MST were the easiest, quickest tools to complete (3-5 min). The present investigation suggested a high prevalence of malnutrition in hospital inpatients and outpatients (19-60% with 'MUST') and 'fair-good' to 'excellent' agreement beyond chance between 'MUST' and most other tools studied. 'MUST' was quick and easy to use in these patient groups.
针对成年人的“营养不良通用筛查工具”（“MUST”）已针对所有医疗环境和患者群体开发，但在筛查以识别营养不良时，其易用性以及与其他已发表工具的一致性需要进行调查。本研究评估了“MUST”与其他多种工具在同一患者中营养不良风险的一致性和患病率，并比较了这些工具的易用性。连续使用“MUST”对患者群体进行筛查，并使用：（1）MEREC公告（MEREC）和希克森与希尔（HH）工具（50名胃肠病门诊患者）；（2）营养风险评分（NRS）和营养不良筛查工具（MST；75名内科住院患者）；（3）简版微型营养评定（MNA - 工具；86名老年患者和85名外科住院患者）；（4）主观全面评定（SGA；50名内科住院患者）；（5）多伊尔营养不良风险评分（URS；52名外科住院患者）。使用“MUST”时，住院患者营养不良风险患病率在19%至60%之间，门诊患者为30%。“MUST”与MEREC、NRS和SGA工具具有“极佳”的一致性（kappa值为0.775 - 0.893），与HH、MST和MNA - 工具具有“良好”的一致性（kappa值为0.551 - 0.711），与URS工具一致性“较差”（kappa值为0.255）。当工具之间营养不良风险分类不同时，除了“MUST”与MNA - 工具（P = 0.0005）和URS（P = 0.039）之间外，并非系统地不同。“MUST”和MST是最容易、最快完成的工具（3 - 5分钟）。本调查表明，医院住院患者和门诊患者中营养不良患病率较高（使用“MUST”时为19%至60%），并且“MUST”与大多数其他研究工具之间存在超出偶然的“良好”至“极佳”一致性。在这些患者群体中，“MUST”使用快速且简便。
