Chites Victória Silva, Burgel Camila Ferri, de Almeida Jussara Carnevale, Silva Flávia Moraes
Medical Sciences Graduate Program in Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Health Science Postgraduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
JPEN J Parenter Enteral Nutr. 2025 Feb;49(2):229-238. doi: 10.1002/jpen.2712. Epub 2025 Jan 6.
Many nutrition risk screening tools include low body mass index (BMI). It remains uncertain whether it affects the validity of these tools in patients with overweight or obesity. We aimed to determine the frequency of malnutrition risk and evaluate its association with hospital length of stay in hospitalized adults according to BMI classification.
Secondary analysis involving inpatients with BMI ≥ 18.5 kg/m. Malnutrition risk was assessed using the Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool, Short Nutritional Assessment Questionnaire, and Nutritional Risk in Emergency-2017. Length of hospital stay, in-hospital mortality, readmission, and mortality within 6 months postdischarge were considered as outcomes.
Among the 582 patients analyzed, the malnutrition risk ranged from 34.5% to 49.7% in patients with normal weight (n = 171), 20.8% to 33.9% in patients with overweight (n = 221), and 5.3% to 22.1% in patients with obesity (n = 190). Malnutrition risk by the NRS-2002 was associated with prolonged hospital stay, regardless of BMI category, and with 6-month hospital readmission in normal weight and those with obesity. The MST was associated with prolonged hospital stay, mortality, and hospital readmission in 6 months in normal-weight patients and with the first two outcomes in patients with overweight. No tool was associated with in-hospital death.
The prognostic value of nutrition risk screening tools varies according to BMI: the MST appears to be more appropriate for normal-weight and overweight patients, whereas the NRS-2002 may be more suitable for patients with obesity.
许多营养风险筛查工具都纳入了低体重指数（BMI）。目前尚不确定这是否会影响这些工具在超重或肥胖患者中的有效性。我们旨在根据BMI分类确定住院成人营养不良风险的发生率，并评估其与住院时间的关联。
对BMI≥18.5kg/m²的住院患者进行二次分析。使用营养风险筛查2002（NRS-2002）、营养不良筛查工具（MST）、营养不良通用筛查工具、简短营养评估问卷和2017年急诊营养风险评估来评估营养不良风险。将住院时间、院内死亡率、再入院率和出院后6个月内的死亡率视为观察指标。
在分析的582例患者中，正常体重患者（n = 171）的营养不良风险为34.5%至49.7%，超重患者（n = 221）为20.8%至33.9%，肥胖患者（n = 190）为5.3%至22.1%。无论BMI类别如何，NRS-2002评估的营养不良风险均与住院时间延长有关，且与正常体重和肥胖患者的6个月再入院率有关。MST与正常体重患者的住院时间延长、死亡率和6个月内再入院率有关，与超重患者的前两个观察指标有关。没有工具与院内死亡相关。
营养风险筛查工具的预后价值因BMI而异：MST似乎更适用于正常体重和超重患者，而NRS-2002可能更适合肥胖患者。
