迷你营养评估-简短形式测试：长期护理机构中老年人的标准和预测效度。
Mini nutritional assessment-short form test: criterion and predictive validity in older adults from a long-term care unity.
机构信息
Faculdade de Ciências da Saúde, Universidade Fernando Pessoa.
Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa (FP-I3ID). Biomedical and Health Sciences (FP-BHS). Faculdade Ciências da Saúde. Universidade Fernando Pessoa.
出版信息
Nutr Hosp. 2023 Aug 28;40(4):763-770. doi: 10.20960/nh.04356.
Introduction: the Mini Nutritional Assessment Short-Form test (MNA-SF) is valid for malnutrition screening and diagnosis of older adults, but few studies evaluated if it predicts hospital length of stay (LOS) and were conducted in long-term care units. Objective: this study aims to evaluate the criterion and predictive validity of MNA-SF. Methods: a prospective observational study was conducted in older adults from a long-term care unity. MNA Long Form test (MNA-LF) and MNA-SF were applied, at admission and at discharge. Percentage of agreement, kappa and intra-class correlation coefficients (ICC) were determined. Sensitivity and specificity of MNA-SF were calculated. The independent association of MNA-SF with LOS (adjustment for Charlson index, sex, age, education) was assessed by Cox regression analysis [results presented as hazard ratio (HR) and 95 % confidence intervals (CI)]. Results: this sample is composed of 109 older adults (62.4 % women), aged 66-102 years. According to MNA-SF at admission, 7.3 % of participants presented normal nutrition status, 55.1 % were at risk of malnutrition and 37.6 % were malnourished. Agreement, kappa and ICC were 83.5 %, 0.692 and 0.768 at admission, and 80.9 %, 0.649 and 0.752 at discharge. MNA-SF sensitivities were 96.7 % at admission and 92.9 % at discharge; specificities were 88.9 % and 89.5 %, at admission and at discharge. According to MNA-SF at discharge, being at risk of malnutrition (HR = 0.170, 95 % CI: 0.055-0.528) or malnourished (HR = 0.059, 95 % CI: 0.016-0.223) lowered the odds of being discharged to home or to usual residence. Conclusions: a high agreement was found between MNA-LF and MNA-SF. MNA-SF revealed high sensitivities and specificities. An independent association was found between risk of malnutrition or malnutrition by MNA-SF and LOS. The use of MNA-SF instead of MNA-LF should be considered in long-term care units given its criterion and predictive validity.
简介
微型营养评估简式量表（MNA-SF）可用于筛查和诊断老年人的营养不良，但很少有研究评估其是否可预测住院时间（LOS），且这些研究都是在长期护理机构中进行的。目的：本研究旨在评估 MNA-SF 的诊断准确性和预测价值。方法：这是一项在长期护理机构中进行的前瞻性观察性研究。在入院时和出院时分别应用 MNA 长式量表（MNA-LF）和 MNA-SF。通过一致性、kappa 系数和组内相关系数（ICC）来评估 MNA-SF 的准确性。计算 MNA-SF 的灵敏度和特异度。通过 Cox 回归分析评估 MNA-SF 与 LOS 的独立关联（调整 Charlson 指数、性别、年龄、教育程度）[结果以危险比（HR）和 95%置信区间（CI）表示]。结果：本研究共纳入 109 名年龄在 66-102 岁的女性（62.4%）老年人。根据入院时的 MNA-SF，7.3%的参与者营养状况正常，55.1%处于营养不良风险中，37.6%则患有营养不良。入院时的一致性、kappa 系数和 ICC 分别为 83.5%、0.692 和 0.768，出院时分别为 80.9%、0.649 和 0.752。入院时和出院时的 MNA-SF 灵敏度分别为 96.7%和 92.9%，特异度分别为 88.9%和 89.5%。根据出院时的 MNA-SF，处于营养不良风险（HR=0.170，95%CI：0.055-0.528）或营养不良（HR=0.059，95%CI：0.016-0.223）的患者出院后回家或回到常住地的可能性较低。结论：MNA-LF 与 MNA-SF 之间存在高度一致性。MNA-SF 具有较高的灵敏度和特异度。MNA-SF 评估的营养不良风险或营养不良与 LOS 之间存在独立关联。鉴于 MNA-SF 的诊断准确性和预测价值，在长期护理机构中使用 MNA-SF 替代 MNA-LF 应予以考虑。
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