Program in Nutrition and Health, Department of Nutrition, Universidade Federal de Lavras, Lavras, Brazil.
Institute of Biological and Health Sciences, Universidade Federal Viçosa, Rio Paranaíba, Brazil.
Nutr Bull. 2023 Jun;48(2):179-189. doi: 10.1111/nbu.12608. Epub 2023 Feb 7.
Understanding of the association between nutritional risk and clinical outcomes in hospitalised patients with overweight is still at an early stage. Given the lack of specific tools for the patient with overweight, the objective of this study was to compare two of the main general screening instruments for assessing nutritional risk in predicting clinical outcomes in a population of hospitalised patients with overweight. A retrospective study was carried out in a medium-sized hospital in Brazil, with patients ≥20 years old admitted between July 2017 and December 2019. Patients who were overweight and had records of Nutritional Risk Screening-2002 (NRS-2002) and Mini-Nutritional Assessment-Short Form (MNA-SF) in their medical files were included in the study. Clinical outcomes data (longer length of stay, readmission during the study period and mortality before the end of study or during hospitalisation) were obtained. The Kappa coefficient assessed agreement between both tools, and their performance for predicting outcomes was analysed using characteristic receiver operating curves (ROC). Data were collected from 643 patients. The prevalence of nutritional risk was 17.7% and 36.1% according to the NRS-2002 and MNA-SF (k = 0.390; p < 0.001), respectively. According to both tools, all clinical outcomes were significantly more common among individuals at nutritional risk (p < 0.05). Only the MNA-SF showed a significant percentage of predictions for readmission (57.2%) and death during hospitalisation (65.7%). For mortality until the end of the study, the area under the ROC curve was similar for MNA-SF (60.5%) and NRS-2002 (60.7%; p = 0.057). The MNA-SF detected a greater proportion of nutritional risk among hospitalised patients with overweight and better predicted all clinical outcomes compared to the NRS-2002 and should be used to screen patients with overweight for nutritional risk.
超重住院患者的营养风险与临床结局之间的关系仍处于早期阶段。鉴于超重患者缺乏特定的工具，本研究的目的是比较两种主要的一般筛查工具，用于评估超重住院患者的营养风险，以预测临床结局。本研究是在巴西一家中型医院进行的回顾性研究，纳入了 2017 年 7 月至 2019 年 12 月期间住院的年龄≥20 岁的超重患者。研究纳入了病历中记录有营养风险筛查 2002 版（NRS-2002）和微型营养评估-短表（MNA-SF）的超重患者。获取了临床结局数据（住院时间延长、研究期间再入院和研究结束前或住院期间死亡）。Kappa 系数评估了两种工具之间的一致性，特征性接收者操作曲线（ROC）分析了它们预测结局的性能。共收集了 643 名患者的数据。根据 NRS-2002 和 MNA-SF，营养风险的患病率分别为 17.7%和 36.1%（k=0.390；p<0.001）。根据这两种工具，所有临床结局在营养风险个体中均更为常见（p<0.05）。只有 MNA-SF 对再入院（57.2%）和住院期间死亡（65.7%）的预测具有显著的百分比。对于研究结束时的死亡率，MNA-SF 的 ROC 曲线下面积与 NRS-2002 相似（60.5%和 60.7%；p=0.057）。MNA-SF 在超重住院患者中检测到更大比例的营养风险，并且与 NRS-2002 相比，更好地预测了所有临床结局，因此应将其用于筛查超重患者的营养风险。
