比较营养风险筛查工具在预测住院患者临床结局中的作用。

Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients.

机构信息

Department of Gastroenterology, Medical School, University of São Paulo-LIM 35, São Paulo, Brazil.

出版信息

Nutrition. 2010 Jul-Aug;26(7-8):721-6. doi: 10.1016/j.nut.2009.07.010. Epub 2009 Dec 5.

DOI:10.1016/j.nut.2009.07.010

PMID:19963352

Abstract

OBJECTIVE

International nutritional screening tools are recommended for screening hospitalized patients for nutritional risk, but no tool has been specifically evaluated in the Brazilian population. The aim of this study was to identify the most appropriate nutritional screening tool for predicting unfavorable clinical outcomes in patients admitted to a Brazilian public university hospital.

METHODS

The Nutritional Risk Screening 2002 (NRS 2002), Mini-Nutritional Assessment-Short Form (MNA-SF), and Malnutrition Universal Screening Tool (MUST) were administered to 705 patients within 48 h of hospital admission. Tool performance in predicting complications, very long length of hospital stay (LOS), and death was analyzed using receiver operating characteristic curves.

RESULTS

NRS 2002, MUST, and MNA-SF identified nutritional risk in 27.9%, 39.6%, and 73.2% of the patients, respectively. NRS 2002 (complications: 0.6531; very long LOS: 0.6508; death: 0.7948) and MNA-SF (complications: 0.6495; very long LOS: 0.6197; death: 0.7583) had largest areas under the ROC curve compared to MUST (complications: 0.6036; very long LOS: 0.6109; death: 0.6363). For elderly patients, NRS 2002 was not significantly different than MNA-SF (P>0.05) for predicting outcomes.

CONCLUSION

Considering current criteria for nutritional risk, NRS 2002 and MNA-SF have similar performance to predict outcomes but NRS 2002 seems to provide a best yield.

摘要

目的

国际营养筛查工具被推荐用于筛查住院患者的营养风险，但尚未有专门针对巴西人群的工具进行评估。本研究旨在确定最适合的营养筛查工具，以预测巴西公立大学附属医院住院患者的不良临床结局。

方法

在入院后 48 小时内，对 705 例患者进行营养风险筛查 2002 版（NRS 2002）、微型营养评估-简短表格版（MNA-SF）和营养不良通用筛查工具（MUST）评估。使用受试者工作特征曲线分析工具预测并发症、超长住院时间（LOS）和死亡的性能。

结果

NRS 2002、MUST 和 MNA-SF 分别识别出 27.9%、39.6%和 73.2%的患者存在营养风险。NRS 2002（并发症：0.6531；超长 LOS：0.6508；死亡：0.7948）和 MNA-SF（并发症：0.6495；超长 LOS：0.6197；死亡：0.7583）的曲线下面积大于 MUST（并发症：0.6036；超长 LOS：0.6109；死亡：0.6363）。对于老年患者，NRS 2002 在预测结局方面与 MNA-SF 无显著差异（P＞0.05）。