Ann Rehabil Med.  2018 Aug;42(4):591-600. 10.5535/arm.2018.42.4.591.

The Nutritional Status and the Clinical Outcomes of Patients With a Spinal Cord Injury Using Nutritional Screening Tools

• Shin JC
• Chang SH
• Hwang SW
• Lee JJ

• KMID: 2420052
• DOI: http://doi.org/10.5535/arm.2018.42.4.591

Abstract

OBJECTIVE
To assess the nutritional status of Korean patients with spinal cord injury (SCI), identify the predictors of undernutrition, and investigate the relationship between undernutrition and clinical outcomes.
METHODS
A retrospective study design was used to determine the nutritional status of 130 patients over 19 years old admitted to the rehabilitation hospital of Yonsei University Health System between June 2015 and February 2017. The nutritional status was assessed using the malnutrition universal screening tool (MUST) and the spinal nutrition screening tool (SNST). The relationship between undernutrition and clinical outcomes was examined by comparing a low-risk group with an at-risk group using a t-test.
RESULTS
Among the SCI patients, 70 (50.8%) were confirmed with undernutrition based on the MUST scores, while 60 (46.2%) had undernutrition based on the SNST scores. It was found that undernutrition has an effect on functional outcomes.
CONCLUSION
We assessed the undernutrition risk in Korean SCI patients, and found that approximately 50% of the patients were at risk of undernutrition. We also found that undernutrition can affect functional recovery.

Keyword

Spinal cord injuries; Malnutrition; Nutrition assessment; Prognosis

MeSH Terms

Humans
Malnutrition
Mass Screening*
Nutrition Assessment
Nutritional Status*
Prognosis
Rehabilitation
Retrospective Studies
Spinal Cord Injuries*
Spinal Cord*

Figure

• 

  Fig. 1. Malnutrition universal screening tool (MUST). Three independent criteria were used to determine the overall risk for malnutrition: current weight status using body mass index (BMI), unintentional weight loss, and acute disease effect that has induced a phase of nothing by mouth for >5 days. Each parameter can be rated as 0, 1, or 2. Overall risk for malnutrition is established as low (score=0), medium (score=1), or high (score≥2).

• 

  Fig. 2. Spinal nutrition screening tool (SNST). Weight was measured to the nearest 0.1 kg using calibrated ward scales or if the patient could not be weighed, then this was estimated or a recently recalled weight was used. Standing height measurement was not realistic. So recalled pre-injury height was used, or height was estimated by one of the alternative methods recommended by the British Association for Parenteral and Enteral Nutrition. Body mass index (BMI) was calculated and weight history scored accordingly. If neither weight nor BMI could be obtained, subjective criteria assessing recent visible weight loss was used. The percentage of unintentional weight loss in the last 3–6 months was calculated from the difference between of pre-injury weight and weight on admission (some, 5%–10%; moderate, 11%–15%; marked, >15%). Age, level of spinal cord injury, presence of co-morbidities, skin condition, diet, appetite, and ability to eat were scored using data obtained from a standardized admission pro forma.

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