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Malnutrition screening tools : comparison against two validated nutrition assessment methods in older medical inpatients

Young, Adrienne M., Kidston, Sarah, Banks, Merrilyn D., Mudge, Alison M., & Isenring, Elisabeth A. (2012) Malnutrition screening tools : comparison against two validated nutrition assessment methods in older medical inpatients. Nutrition, 29(1), pp. 101-106.

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Abstract

Objective

Although several validated nutritional screening tools have been developed to “triage” inpatients for malnutrition diagnosis and intervention, there continues to be debate in the literature as to which tool/tools clinicians should use in practice. This study compared the accuracy of seven validated screening tools in older medical inpatients against two validated nutritional assessment methods.

Methods

This was a prospective cohort study of medical inpatients at least 65 y old. Malnutrition screening was conducted using seven tools recommended in evidence-based guidelines. Nutritional status was assessed by an accredited practicing dietitian using the Subjective Global Assessment (SGA) and the Mini-Nutritional Assessment (MNA). Energy intake was observed on a single day during first week of hospitalization.

Results

In this sample of 134 participants (80 ± 8 y old, 50% women), there was fair agreement between the SGA and MNA (κ = 0.53), with MNA identifying more “at-risk” patients and the SGA better identifying existing malnutrition. Most tools were accurate in identifying patients with malnutrition as determined by the SGA, in particular the Malnutrition Screening Tool and the Nutritional Risk Screening 2002. The MNA Short Form was most accurate at identifying nutritional risk according to the MNA. No tool accurately predicted patients with inadequate energy intake in the hospital.

Conclusion

Because all tools generally performed well, clinicians should consider choosing a screening tool that best aligns with their chosen nutritional assessment and is easiest to implement in practice. This study confirmed the importance of rescreening and monitoring food intake to allow the early identification and prevention of nutritional decline in patients with a poor intake during hospitalization.

Impact and interest:

9 citations in Scopus
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7 citations in Web of Science®

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ID Code: 52946
Item Type: Journal Article
Keywords: Malnutrition, discharge planning, interdisciplinary care
DOI: 10.1016/j.nut.2012.04.007
ISSN: 0899-9007
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 2012 Elsevier
Copyright Statement: This is the author’s version of a work that was accepted for publication in Nutrition. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Nutrition, 29(1), (2013)] DOI: 10.1016/j.nut.2012.04.007
Deposited On: 07 Aug 2012 09:29
Last Modified: 04 Feb 2014 20:31

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