School of Life Sciences, Brayford Pool Campus, Lincoln, Lincolnshire LN6 7TS, UK.
Lincoln Hospital, ULHT, Lincoln, Lincolnshire LN2 5QY, UK.
Clin Nutr. 2015 Apr;34(2):296-301. doi: 10.1016/j.clnu.2014.04.013. Epub 2014 May 2.
BACKGROUND & AIMS: This cohort study aimed to investigate and compare the ability to predict malnutrition in a group of frail older hospital patients in the United Kingdom using the nutritional risk screening tools, MUST (malnutrition universal screening tool), MNA-SF(®) (mini nutritional assessment-short form) and bioelectrical impedance assessment (BIA) of body composition.
MUST and MNA-SF was performed on 78 patients (49 males and 29 females, age: 82 y ± 7.9, body mass index (BMI): 25.5 kg/m(2) ± 5.4), categorised by nutritional risk, and statistical comparison and test reliability performed. BIA was performed in 66 patients and fat free mass (FFM), fat mass (FM) and body cell mass (BCM) and index values (kg/m(2)) calculated and compared against reference values.
MUST scored 77% patients 'low risk', 9% 'medium risk' and 14% 'high risk', compared to MNA-SF categorisation: 9%, 46% and 45%, respectively (P < 0.000001). Reliability assessment found poor reliability between the screening tools (coefficient, r = 0.4). Significant positive correlations were found between most variables (P < 0.05-<0.001); although females exhibited greater variation. FFM index analysis found 40% of males low/depleted, 21% borderline/at risk with 96% categorised by MNA-SF as either malnourished or at risk (MUST-35%). 29% males had low FM index and all appropriately classified by MNA-SF. 30% females had low FFM index or borderline, MNA-SF screening appropriately categorised 86% (compared to MUST-29%).
This preliminary data may have significant clinical implications and highlights the potential ability of the MNA-SF and BIA to accurately assess malnutrition risk over MUST in frail older hospital patients.
本队列研究旨在调查和比较营养风险筛查工具，即 MUST（营养不良通用筛查工具）、MNA-SF（®）（迷你营养评估-简短形式）和身体成分的生物电阻抗评估（BIA），在英国一组虚弱的老年住院患者中预测营养不良的能力。
对 78 名患者（49 名男性和 29 名女性，年龄：82 岁±7.9 岁，体重指数（BMI）：25.5kg/m2±5.4）进行 MUST 和 MNA-SF 检测，并根据营养风险进行分类，进行统计比较和测试可靠性分析。对 66 名患者进行 BIA 检测，计算并比较无脂肪质量（FFM）、脂肪质量（FM）和身体细胞质量（BCM）和指数值（kg/m2）与参考值。
MUST 评分 77%的患者为“低风险”，9%为“中风险”，14%为“高风险”，而 MNA-SF 分类分别为：9%、46%和 45%（P<0.000001）。可靠性评估发现筛查工具之间的可靠性较差（系数，r=0.4）。大多数变量之间存在显著的正相关（P<0.05-<0.001）；尽管女性表现出更大的变化。FFM 指数分析发现 40%的男性低/耗竭，21%的男性边缘/有风险，96%的男性根据 MNA-SF 分类为营养不良或有风险（MUST-35%）。29%的男性 FM 指数较低，所有男性均通过 MNA-SF 进行适当分类。30%的女性 FFM 指数较低或边缘状态，MNA-SF 筛查适当分类 86%（与 MUST-29%相比）。
这些初步数据可能具有重要的临床意义，并强调了 MNA-SF 和 BIA 在评估虚弱的老年住院患者营养不良风险方面比 MUST 更准确的潜力。
