Nursal Tarik Zafer, Noyan Turgut, Atalay Betül Gülşen, Köz Nazmiye, Karakayali Hamdi
Department of General Surgery, Adana Teaching and Research Center, Başkent University, Turkey.
Nutrition. 2005 Jun;21(6):659-65. doi: 10.1016/j.nut.2004.10.016.
Malnutrition in hospitalized patients is a major problem that is underdiagnosed. Early recognition of malnutrition is important for nutritional support to be effective. Our aims were to determine the malnutrition rate at our center and to devise an effective screening tool for identifying patients at risk for malnutrition.
This prospective study included 2211 patients. Each subject was assessed for malnutrition by the Subjective Global Assessment (SGA), and combination criteria (CC), which included anthropometric measurements and laboratory testing. Findings based on these methods were compared with findings in a series of malnutrition screening tests (malnutrition screening tool, self-assessment portion of a mini-nutritional assessment, a question about unintentional weight loss, evaluation of loss of subcutaneous fat, and various combinations of these).
The SGA and CC methods identified 242 (11.0%) and 345 (15.6%) patients as malnourished, respectively. Of the screening methods that were tested, the combination of unintentional weight loss and loss of subcutaneous fat proved to be the most valuable, with 93% accuracy for predicting malnutrition according to the SGA, and 82.9% accuracy for predicting malnutrition according to CC. The corresponding negative predictive values were 95.5% and 87.3%.
The results show that this simple two-part nutritional screening tool (unintentional weight loss and loss of subcutaneous fat) is valuable for identifying malnutrition according to the SGA and CC at our institution; however, its validity must be confirmed at other centers.
住院患者的营养不良是一个未得到充分诊断的主要问题。早期识别营养不良对于有效的营养支持很重要。我们的目的是确定我们中心的营养不良率，并设计一种有效的筛查工具来识别有营养不良风险的患者。
这项前瞻性研究纳入了2211名患者。通过主观全面评定法（SGA）和综合标准（CC）对每位受试者进行营养不良评估，综合标准包括人体测量和实验室检测。将基于这些方法的结果与一系列营养不良筛查测试（营养不良筛查工具、微型营养评定法的自我评估部分、一个关于非故意体重减轻的问题、皮下脂肪减少的评估以及这些项目的各种组合）的结果进行比较。
SGA和CC方法分别将242名（11.0%）和345名（15.6%）患者判定为营养不良。在所测试的筛查方法中，非故意体重减轻和皮下脂肪减少的组合被证明是最有价值的，根据SGA预测营养不良的准确率为93%，根据CC预测营养不良的准确率为82.9%。相应的阴性预测值分别为95.5%和87.3%。
结果表明，这种简单的两部分营养筛查工具（非故意体重减轻和皮下脂肪减少）对于根据我们机构的SGA和CC识别营养不良很有价值；然而，其有效性必须在其他中心得到证实。
