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ThedaCare 营养风险筛查与 2002 营养风险筛查相比,可提高非重症监护病房患者营养不良风险的识别率。

ThedaCare Nutrition Risk Screen Improves the Identification of Non-Intensive Care Unit Patients at Risk for Malnutrition Compared With the Nutrition Risk Screen 2002.

机构信息

ThedaCare Regional Medical Center, Appleton and Neenah, Wisconsin, USA.

Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.

出版信息

JPEN J Parenter Enteral Nutr. 2019 Jan;43(1):70-80. doi: 10.1002/jpen.1315. Epub 2018 Jun 30.

Abstract

BACKGROUND

Identification of patients at risk for malnutrition is important for timely nutrition intervention to reduce morbidity and mortality.

OBJECTIVE

The objective of this study was to compare the sensitivity and specificity of the Nutrition Risk Screen (NRS) 2002 and the ThedaCare NRS to identify patients at risk for malnutrition.

METHODS

The NRS 2002 and ThedaCare NRS were administered to 594 patients, aged 63 ± 16 years (mean ± SD), in the non-intensive care unit hospital setting. Risk for malnutrition and malnutrition diagnosis were confirmed with the 6 malnutrition clinical characteristics defined by the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition and using the nutrition assessment that included the Nutrition Focused Physical Exam. Sensitivity, specificity, and κ coefficient were calculated.

RESULTS

When compared with the NRS 2002, the ThedaCare NRS had higher sensitivity (98.8% vs 63.5%), indicating improved identification of patients at risk for malnutrition, but lower specificity (74.0% vs 93.4%), indicating that more patients at low risk for malnutrition were misclassified. ThedaCare NRS missed fewer patients at risk for malnutrition when compared with the NRS 2002. ThedaCare NRS had a higher κ coefficient when compared with the NRS 2002, indicating better agreement of results regardless of who administered the screen. The ThedaCare NRS required less time to complete when compared with the NRS 2002 (mean ± SE: ThedaCare, 17 ± 1 seconds; NRS 2002, 9 ± 1 minutes; P < .0001).

CONCLUSION

The ThedaCare NRS improves the identification of patients at risk for malnutrition in the non-intensive care unit hospital setting. This trial was registered at www.clinicaltrials.gov as NCT02585245.

摘要

背景

识别有营养不良风险的患者对于及时进行营养干预以降低发病率和死亡率非常重要。

目的

本研究旨在比较营养风险筛查 2002 版(NRS 2002)和 ThedaCare NRS 筛查工具对识别有营养不良风险患者的敏感性和特异性。

方法

在非重症监护病房的医院环境中,对 594 名年龄 63 ± 16 岁(平均值 ± 标准差)的患者进行 NRS 2002 和 ThedaCare NRS 评估。采用美国营养与饮食学会和美国肠外与肠内营养学会定义的 6 项营养不良临床特征以及包含营养重点体检的营养评估来确认营养不良风险和营养不良诊断。计算敏感性、特异性和 κ 系数。

结果

与 NRS 2002 相比,ThedaCare NRS 的敏感性更高(98.8%对 63.5%),表明它能更好地识别有营养不良风险的患者,但特异性更低(74.0%对 93.4%),表明更多低营养不良风险的患者被错误分类。与 NRS 2002 相比,ThedaCare NRS 漏诊的营养不良风险患者更少。与 NRS 2002 相比,ThedaCare NRS 的 κ 系数更高,表明无论谁进行了筛查,结果的一致性都更好。与 NRS 2002 相比,ThedaCare NRS 完成评估所需的时间更短(平均值 ± 标准误:ThedaCare,17 ± 1 秒;NRS 2002,9 ± 1 分钟;P<0.0001)。

结论

ThedaCare NRS 可提高非重症监护病房医院环境中识别有营养不良风险患者的能力。本试验在 www.clinicaltrials.gov 上注册,编号为 NCT02585245。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf86/7379985/90b165307ef2/JPEN-43-70-g001.jpg

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