Sharma Yogesh, Avina Peter, Ross Emelie, Horwood Chris, Hakendorf Paul, Thompson Campbell
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Flinders Medical Centre, Adelaide, SA, Australia.
Gerontol Geriatr Med. 2022 Jul 6;8:23337214221107817. doi: 10.1177/23337214221107817. eCollection 2022 Jan-Dec.
The malnutrition-universal-screening-tool (MUST) is commonly used for screening malnutrition in hospitalised patients but its utility in the detection of frailty is unknown. This study determined the utility of MUST in detection of frailty in older hospitalised patients. This prospective-study enrolled 243 patients ⩾65 years in a tertiary-teaching hospital in Australia. Patients with a MUST score of ⩾1 were classified as at-risk of malnutrition. Frailty status was determined by the Edmonton-Frail-Scale (EFS) and patients with an EFS score of >8 were classified as frail. We validated the MUST against the EFS by plotting a receiver-operating-characteristic-curve (ROC) curve and area-under-the-curve (AUC) was determined. The mean (SD) age was 83.9 (6.5) years and 126 (51.8%) were females. The EFS determined 149 (61.3%) patients as frail, while 107 (44.1%) patients were at-risk of malnutrition according to the MUST. There was a positive linear but weak association between the MUST and the EFS scores (Pearson's correlation coefficient= .22, 95% CI .12- .36, < .001). The sensitivity, specificity, positive and negative predictive value of MUST in the detection of frailty was 51%, 67%, 78.5% and 37%, respectively and the AUC was .59 (95% CI .53-.65, < .001). The MUST is moderately sensitive in detection of frailty in older-hospitalised patients.
营养不良通用筛查工具（MUST）常用于筛查住院患者的营养不良情况，但其在检测衰弱方面的效用尚不清楚。本研究确定了MUST在检测老年住院患者衰弱情况中的效用。这项前瞻性研究在澳大利亚一家三级教学医院纳入了243名年龄≥65岁的患者。MUST评分≥1的患者被归类为有营养不良风险。通过埃德蒙顿衰弱量表（EFS）确定衰弱状态，EFS评分>8的患者被归类为衰弱。我们通过绘制受试者工作特征曲线（ROC）来验证MUST与EFS的相关性，并确定曲线下面积（AUC）。平均（标准差）年龄为83.9（6.5）岁，女性有126名（51.8%）。根据EFS，149名（61.3%）患者被判定为衰弱，而根据MUST，107名（44.1%）患者有营养不良风险。MUST与EFS评分之间存在正线性但较弱的关联（Pearson相关系数=0.22，95%CI 0.12 - 0.36，P<0.001）。MUST在检测衰弱方面的敏感性、特异性、阳性预测值和阴性预测值分别为51%、67%、78.5%和37%，AUC为0.59（95%CI 0.53 - 0.65，P<0.001）。MUST在检测老年住院患者衰弱方面具有中等敏感性。
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