SNAQ（RC），一个简易的信号灯系统，作为在养老院中识别营养不良的第一步。
The SNAQ(RC), an easy traffic light system as a first step in the recognition of undernutrition in residential care.
机构信息
Department of Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands.
出版信息
J Nutr Health Aging. 2010 Feb;14(2):83-9. doi: 10.1007/s12603-009-0147-1.
OBJECTIVE
Development and validation of a quick and easy screening tool for the early detection of undernourished residents in nursing homes and residential homes.
DESIGN
Multi-center, cross sectional observational study.
SETTING
Nursing homes and residential homes.
PARTICIPANTS
The screening tool was developed in a total of 308 residents (development sample; sample A) and cross validated in a new sample of 720 residents (validation sample) consisting of 476 nursing home residents (Sample B1) and 244 residential home residents (sample B2).
MEASUREMENTS
Patients were defined severely undernourished when they met at least one of the following criteria: BMI <or= 20 kg/m2 and/or >or= 5% unintentional weight loss in the past month and/or >or= 10% unintentional weight loss in the past 6 months. Patients were defined as moderately undernourished if they met the following criteria: BMI 20.1-22 kg/m2 and/or 5-10% unintentional weight loss in the past six months. The most predictive questions (originally derived from previously developed screening instruments) of undernourishment were selected in sample A and cross validated in sample B. In a second stage BMI was added to the SNAQRC in sample B. The diagnostic accuracy of the screening tool in the development and validation samples was expressed in sensitivity, specificity, and the negative and positive predictive value.
RESULTS
The four most predictive questions for undernutrition related to: unintentional weight loss more than 6 kg during the past 6 months and more than 3 kg in the past month, capability of eating and drinking with help, and decreased appetite during the past month. The diagnostic accuracy of these questions alone was insufficient (Se=45%, Sp=87%, PPV=50% and NPV=84%). However, combining the questions with measured BMI sufficiently improved the diagnostic accuracy (Se=87%, Sp=82%, PPV=59% and NPV=95%).
CONCLUSION
Early detection of undernourished nursing- and residential home residents is possible using four screening questions and measured BMI.
目的
开发并验证一种用于早期发现养老院和住宿护理机构中营养不良居民的快速简便筛选工具。
设计
多中心、横断面观察性研究。
设置
养老院和住宿护理机构。
参与者
该筛选工具在总共 308 名居民（开发样本；样本 A）中进行了开发，并在由 720 名居民组成的新样本中进行了交叉验证（验证样本），其中包括 476 名养老院居民（样本 B1）和 244 名住宿护理机构居民（样本 B2）。
测量
当患者符合以下至少一项标准时，定义为严重营养不良：BMI<or=20kg/m2 且/或过去一个月内非故意体重下降>or=5%，或过去 6 个月内非故意体重下降>or=10%。当患者符合以下标准时，定义为中度营养不良：BMI 20.1-22kg/m2 且/或过去 6 个月内非故意体重下降 5-10%。在样本 A 中选择最具预测性的问题（最初源自先前开发的筛选工具）来筛选营养不良，并在样本 B 中进行交叉验证。在第二阶段，BMI 被添加到样本 B 的 SNAQRC 中。在开发和验证样本中，该筛选工具的诊断准确性以敏感性、特异性、阴性和阳性预测值表示。
结果
与营养不良相关的四个最具预测性的问题涉及：过去 6 个月体重非故意下降超过 6kg 且过去 1 个月体重非故意下降超过 3kg、需要帮助进食和饮水的能力、以及过去 1 个月内食欲减退。这些问题单独的诊断准确性不足（Se=45%，Sp=87%，PPV=50%和 NPV=84%）。然而，将这些问题与测量的 BMI 相结合，可以显著提高诊断准确性（Se=87%，Sp=82%，PPV=59%和 NPV=95%）。
结论
使用四个筛选问题和测量的 BMI 可以早期发现营养不良的养老院和住宿护理机构居民。
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