Unidad de Nutrición, Hospital General Universitario Gregorio Marañón, c/Doctor Esquerdo no. 46, Madrid, Spain.
Eur J Clin Nutr. 2011 Feb;65(2):269-74. doi: 10.1038/ejcn.2010.243. Epub 2010 Nov 17.
BACKGROUND/OBJECTIVES: The prevalence of malnutrition in hospitals is high. No nutritional screening tool is considered the gold standard for identifying nutritional risk. The aims of this study were to evaluate nutritional risk in hospitalized patients using four nutritional screening tools.
SUBJECTS/METHODS: Four nutritional screening tools were evaluated: nutritional risk screening (NRS-2002), the malnutrition universal screening tool (MUST), the subjective global assessment (SGA) and the mini nutritional assessment (MNA). Patients were assessed within the first 36 h after hospital admission. Date of admission, diagnosis, complications and date of discharge were collected. To compare the tools, the results were reorganized into: patients at risk and patients with a good nutritional status. The statistical analysis included the χ(2)-test to assess differences between the tests and the κ statistic to assess agreement between the tests.
The study sample comprised 400 patients (159 women, 241 men), mean age 67.3 (16.1) years. The prevalence of patients at nutritional risk with the NRS-2002, MUST, SGA and MNA was 34.5, 31.5, 35.3 and 58.5%, respectively. Statistically significant differences were observed between the four nutritional screening tools (P<0.001). The agreement between the tools was quite good except for the MNA (MNA-SGA κ=0.491, NRS-2002-SGA κ=0.620 and MUST-SGA κ=0.635). Patients at nutritional risk developed more complications during admission and had an increased length of stay.
The prevalence of nutritional risk in hospitalized patients was high with all the tools used. The best agreement between the tools was for NRS-2002 with SGA and MUST with SGA. At admission, NRS-2002 and MUST should be used to screen for nutritional status.
背景/目的：医院营养不良的患病率很高。目前还没有一种营养筛查工具被认为是识别营养风险的金标准。本研究旨在使用四种营养筛查工具评估住院患者的营养风险。
受试者/方法：评估了四种营养筛查工具：营养风险筛查（NRS-2002）、营养不良通用筛查工具（MUST）、主观全面评估（SGA）和微型营养评估（MNA）。患者在入院后 36 小时内进行评估。收集入院日期、诊断、并发症和出院日期。为了比较这些工具，将结果重新整理为：有风险的患者和营养状况良好的患者。统计分析包括卡方检验来评估不同测试之间的差异和κ 统计量来评估测试之间的一致性。
研究样本包括 400 名患者（159 名女性，241 名男性），平均年龄为 67.3（16.1）岁。NRS-2002、MUST、SGA 和 MNA 评估的有营养风险的患者比例分别为 34.5%、31.5%、35.3%和 58.5%。四种营养筛查工具之间存在显著差异（P<0.001）。除了 MNA（MNA-SGA κ=0.491、NRS-2002-SGA κ=0.620 和 MUST-SGA κ=0.635）外，其他工具之间的一致性相当好。有营养风险的患者在住院期间发生更多并发症，住院时间更长。
使用所有工具评估，住院患者的营养风险患病率都很高。MNA 与 SGA、NRS-2002 与 SGA 之间的一致性最好。入院时，应使用 NRS-2002 和 MUST 筛查营养状况。
