St. Michael's Hospital, Unity Health Toronto, Toronto, ON.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON.
Can J Diet Pract Res. 2024 Sep 1;85(3):157-160. doi: 10.3148/cjdpr-2024-002. Epub 2024 Jul 10.
Individuals receiving hemodialysis are at increased risk of malnutrition; however, regular diagnosis of malnutrition using subjective global assessment (SGA) is time-consuming. This study aimed to determine whether the Canadian Nutrition Screening Tool (CNST) or the Geriatric Nutrition Risk Index (GNRI) screening tools could accurately identify hemodialysis patients at risk for malnutrition. A retrospective medical chart review was conducted for in-centre day shift hemodialysis patients (n = 95) to obtain the results of the SGA assessment and the CNST screener and to calculate the GNRI score. Sensitivity and specificity analyses showed only a fair agreement between the SGA and CNST (sensitivity = 20%; specificity 96%; κ = .210 (95% CI, -0.015 to .435), < .05) and between the SGA and GNRI (sensitivity = 35%; specificity = 88%; κ = .248 (95% CI, .017 to .479), < .05). There was no significant statistical difference between the accuracy of either tool in identifying patients at risk of malnutrition ( = .50). The CNST and GNRI do not accurately screen for risk of malnutrition in the hemodialysis population; therefore, further studies are needed to determine an effective malnutrition screening tool in this population.
接受血液透析的个体发生营养不良的风险增加；然而，使用主观全面评估（SGA）定期诊断营养不良既耗时又费力。本研究旨在确定加拿大营养筛查工具（CNST）或老年营养风险指数（GNRI）筛查工具是否能够准确识别血液透析患者的营养不良风险。对中心日间血液透析患者（n=95）进行了回顾性病历审查，以获得 SGA 评估和 CNST 筛查器的结果，并计算 GNRI 评分。敏感性和特异性分析显示，SGA 和 CNST 之间只有适度的一致性（敏感性=20%；特异性 96%；κ=.210（95% CI，-0.015 至.435）， <.05），SGA 和 GNRI 之间也只有适度的一致性（敏感性=35%；特异性=88%；κ=.248（95% CI，.017 至.479）， <.05）。两种工具在识别营养不良风险患者方面的准确性没有显著统计学差异（ =.50）。CNST 和 GNRI 不能准确筛查血液透析人群的营养不良风险；因此，需要进一步的研究来确定该人群中有效的营养不良筛查工具。
