J Nutr Health.  2014 Apr;47(2):124-133. 10.4163/jnh.2014.47.2.124.

Development of a simplified malnutrition screening tool for hospitalized patients and evaluation of its inter-methods reliability

Affiliations
  • 1Department of Clinical Health Sciences, Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 120-750, Korea.
  • 2Nutrition Team, Korea Institute of Radiological and Medical Sciences, Seoul 139-709, Korea.
  • 3Department of Nutritional Sciences & Food Management, College of Health Sciences, Ewha Womans University, Seoul 120-750, Korea. park.yoonjung@ewha.ac.kr

Abstract

PURPOSE
The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospi-talized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002.
METHODS
Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGS-GA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hema-tocrit, and changes in body weight and food intake, were statistically selected as variables for SMST.
RESULTS
Accord-ing to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, kappa = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, kappa = 0.505), respectively, indicating that SMST held high inter-methods reliability.
CONCLUSION
In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

Keyword

nutrition screening; malnutrition; nutritional status; hospitalized patients

MeSH Terms

Body Weight
Cholesterol
Eating
Hematocrit
Humans
Length of Stay
Malnutrition*
Mass Screening*
Nutritional Status
Sensitivity and Specificity
Cholesterol

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