Department of Nutrition, Laikon General Hospital, Athens, Greece.
Clin Nutr. 2012 Jun;31(3):378-85. doi: 10.1016/j.clnu.2011.11.017. Epub 2011 Dec 17.
BACKGROUND & AIMS: Malnutrition in the elderly is a multifactorial problem, more prevalent in hospitals and care homes. The absence of a gold standard in evaluating nutritional risk led us to evaluate the efficacy of six nutritional screening tools used in the elderly.
Two hundred forty eight elderly patients (129 men, 119 female women, aged 75.2 ± 8.5 years) were examined. Nutritional screening was performed on admission using the following tools: Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), Subjective Global Assessment (SGA), Mini Nutritional Assessment - Screening Form (MNA-SF), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated.
Nutritional risk and/or malnutrition varied greatly, ranging from 47.2 to 97.6%, depending on the nutritional screening tool used. MUST was the most valid screening tool (validity coefficient = 0.766, CI 95%: 0.690-0.841), while SGA was in better agreement with the combined index (κ = 0.707, p = 0.000). NRS 2002 although was the highest in sensitivity (99.4%), it was the lowest in specificity (6.1%) and positive predictive value (68.2%).
MUST seem to be the most valid in the evaluation of the risk for malnutrition in the elderly upon admission to the hospital. NRS 2002 was found to overestimate nutritional risk in the elderly.
老年人营养不良是一个多因素问题，在医院和养老院更为普遍。由于缺乏评估营养风险的金标准，我们评估了六种用于老年人的营养筛查工具的疗效。
检查了 248 名老年患者（129 名男性，119 名女性，年龄 75.2±8.5 岁）。入院时使用以下工具进行营养筛查：营养风险指数（NRI）、老年营养风险指数（GNRI）、主观整体评估（SGA）、微型营养评估-筛查表（MNA-SF）、营养不良通用筛查工具（MUST）和营养风险筛查 2002（NRS 2002）。还计算了一个营养不良综合指数。
营养风险和/或营养不良差异很大，根据使用的营养筛查工具，范围从 47.2%到 97.6%。MUST 是最有效的筛查工具（有效性系数为 0.766，95%CI：0.690-0.841），而 SGA 与综合指数的一致性更好（κ=0.707，p=0.000）。虽然 NRS 2002 的敏感性最高（99.4%），但其特异性（6.1%）和阳性预测值（68.2%）最低。
MUST 似乎是评估老年人入院时营养不良风险最有效的方法。NRS 2002 被发现高估了老年人的营养风险。
