医院住院患者中最小饮食观察和营养表单 - 第二版（MEONF-II）的截断分数。

Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) among hospital inpatients.

机构信息

Department of Clinical Nursing Sciences, School of Health and Society, Kristianstad University, Kristianstad, Sweden.

出版信息

Food Nutr Res. 2011;55. doi: 10.3402/fnr.v55i0.7289. Epub 2011 Jul 29.

DOI:10.3402/fnr.v55i0.7289

PMID:21814520

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3149411/

Abstract

BACKGROUND AND OBJECTIVE

The newly developed Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.

DESIGN

Cross-sectional study.

METHODS

The study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity-1).

RESULTS

According to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.

CONCLUSIONS

The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

摘要

背景与目的

新开发的简化饮食观察与营养评估表-第二版（MEONF-II）在与微型营养评估（MNA）的相关性方面表现出了较高的敏感性和特异性。然而，用于决定低/中度和高营养风险（UN）的建议 MEONF-II 截断分数（>2 和>4）并非基于统计标准，而是基于临床推理。本研究的目的是根据统计标准，结合已确立的 MNA，确定 MEONF-II 的最佳截断分数。

设计

横断面研究。

方法

该研究纳入了 187 名接受 MNA（完整版本）评估营养状况的患者，并进行了 MEONF-II 筛查。MEONF-II 包括非自愿性体重减轻、身体质量指数（BMI）（或小腿围）、饮食困难以及 UN 临床体征的评估。通过受试者工作特征（ROC）曲线和曲线下面积（AUC）分析 MEONF-II 数据；通过约登指数（J=敏感性+特异性-1）确定最佳截断值。

结果

根据 MEONF-II，41%的患者处于中度或高度 UN 风险，根据 MNA，50%的患者处于风险或已经营养不良状态。建议的截断分数得到了约登指数的支持。MEONF-II 用于识别任何 UN 风险水平的较低截断值（>2；J=0.52）的总体准确性为 76%，AUC 为 80%。用于识别高 UN 风险的较高截断值（>4；J=0.33）的准确性为 63%，AUC 为 70%。