Abstract

CALLEJA FERNANDEZ, Alicia; VIDAL CASARIEGO, Alfonso; CANO RODRIGUEZ, Isidoro  and  BALLESTEROS POMAR, María D.. Efficacy and effectiveness of different nutritional screening tools in a tertiary hospital. Nutr. Hosp. [online]. 2015, vol.31, n.5, pp.2240-2246. ISSN 1699-5198.  https://dx.doi.org/10.3305/nh.2015.31.5.8606.

Introduction: The high prevalence of malnutrition in hospitals and its impact make the use of a nutritional screening tool necessary for its detection, diagnosis and early treatment. Objective: To evaluate the most appropriate tool for nutritional screening, globally and by hospital wards, in a tertiary hospital. Methodology: cross-sectional study in routine clinical practice. Four nutritional screening tools were evaluated: Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), Malnutrition Universal Screening Tool (MUST), and Nutritional Risk Screening 2002 (NRS-2002). Hospital wards were grouped into: medical wards, General Surgery, Orthopedics, other surgical wards, and Oncology-Hematology. A statistical analysis of sensitivity (S) and specificity (Sp) were performed, and were compared using ROC curve. Results: There were evaluated 201 patients with median age of 71.6 (RIC 21.4) years and 51.2% were women. The prevalence of nutritional risk (NR) and malnutrition (MN) was: SGS 62.1%, 68.6% MNA, MUST 53.7%, and NRS-2002 35.8%. All the evaluated nutritional screening tools, except MNA, detected a higher prevalence of RN and DN in the medical wards than surgical wards. In the overall analysis the MNA obtained S=93.3%, Sp=71.6% and an area under the ROC curve of 0.825; the MUST obtained S=82.4%, Sp=93.4% and an area under the ROC curve of 0.879; NRS-2002 obtained S=56.0%, Sp=97.4% and an area under the ROC curve of 0.766. These results were similar in the analysis by hospital wards. Conclusion: MUST could be the recommended nutritional screening tool to use in a tertiary hospital with elderly population, as the overall good results of sensitivity and specificity, as well as its simplicity.

Keywords : Malnutrition; Nutritional screening tool.

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