Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Gerontology, Dezhou People's Hospital, Shandong, China.
Asia Pac J Clin Nutr. 2021;30(1):1-6. doi: 10.6133/apjcn.202103_30(1).0001.
Malnutrition in elderly individuals is extremely common. In China, Nutritional Risk Screening 2002 (NRS-2002) is often used to assess malnutrition in hospitalized elderly patients, although a gold standard for elderly outpatients is lacking. The Nutrition Screening Initiative Checklist (NSI) and Malnutrition Screening Tool (MST) have seldom been validated in elderly outpatients. This open, parallel, multi-center, cross-sectional study evaluated the performance of NRS-2002, the NSI, and the MST in estimating malnutrition risk in elderly outpatients.
This study included 986 elderly outpatients, with 53.2% being women, from five clinical teaching hospitals in Beijing. The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the tools were estimated using a body mass index (BMI) of <18.5 kg/m2 as a reference.
The mean (range) age of the patients was 69.6±6.8 (60-100) years. Overall, 4.3% had BMI <18.5 kg/m2, 16.8% scored ≥3 points in NRS-2002, 9.8% scored ≥2 points in the MST, and 37.0% scored ≥3 points in the NSI. NRS-2002 had the highest sensitivity and the best AUC (0.934 vs. 0.642 for the NSI and 0.660 for the MST, p<0.05), and the MST had the highest specificity. The sensitivity and specificity of the NSI were 0.64 and 0.64, respectively.
NRS-2002 had the highest validity, and the MST had the highest specificity in estimating the risk of malnutrition in elderly outpatients. However, the accuracy of the NSI should be further verified with large samples.
老年人营养不良极其常见。在中国，营养风险筛查 2002（NRS-2002）常用于评估住院老年患者的营养不良情况，但缺乏老年人门诊的金标准。营养筛查倡议清单（NSI）和营养不良筛查工具（MST）在老年人门诊中很少得到验证。本开放性、平行、多中心、横断面研究评估了 NRS-2002、NSI 和 MST 在估计老年门诊患者营养不良风险方面的性能。
该研究纳入了来自北京 5 家临床教学医院的 986 名老年门诊患者，其中 53.2%为女性。使用 BMI<18.5kg/m2 作为参考，估计工具的灵敏度、特异性和受试者工作特征曲线下面积（AUC）。
患者的平均（范围）年龄为 69.6±6.8（60-100）岁。总体而言，4.3%的患者 BMI<18.5kg/m2，16.8%的患者 NRS-2002 评分≥3 分，9.8%的患者 MST 评分≥2 分，37.0%的患者 NSI 评分≥3 分。NRS-2002 的灵敏度最高，AUC 最佳（0.934 对 NSI 的 0.642 和 MST 的 0.660，p<0.05），MST 的特异性最高。NSI 的灵敏度和特异性分别为 0.64 和 0.64。
NRS-2002 评估老年门诊患者营养不良风险的有效性最高，MST 的特异性最高。但 NSI 的准确性需要进一步用大样本验证。
