The two most popular malnutrition screening tools in the light of the new ESPEN consensus definition of the diagnostic criteria for malnutrition
The two most popular malnutrition screening tools in the light of the new ESPEN consensus definition of the diagnostic criteria for malnutrition
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DOI：
10.1016/j.clnu.2016.07.014
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发表时间：
2017-08-01
影响因子：
6.3
通讯作者：
Chourdakis, Michael
中科院分区：
文献类型：
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作者：
Poulia, Kalliopi-Anna;Klek, Stanislaw;Chourdakis, Michael
背景：欧洲临床营养和代谢学会(ESPEN)最近提出的成人营养不良的新定义改变了人们对这一问题的看法，并提出了现有诊断工具的可靠性问题。因此，本研究的目的是通过与新的Espen标准进行比较，验证两种最常用的营养筛查工具的准确性。方法：对1146例(中位年龄60岁，四分位数范围：44~73岁，男性617例，女性529例)入院时使用两种营养筛查工具：营养风险筛查2002(NRS2002)和营养不良通用筛查工具(MUST)进行营养筛查。结果：根据NRS2002诊断标准，门诊和住院患者中、高度营养不良的风险分别为13.5%和27.9%。使用该药后，9.1%的门诊患者和14.9%的住院患者处于中/高度营养不良风险。根据Espen诊断标准，分别有6.4%的门诊患者和11.3%的住院患者被归类为营养不良。与NRS2002(K=0.256，p<；0.001和k=0.228，p<；0.001)相比，门诊患者(K=0.777，p<；0.001)和住院患者(K=0.843，p<；0.001)必须与后者有更好的相关性。与NRS2002相比，MUSY的ROC曲线下面积(AUC)更高(门诊患者分别为0.964和0.695，住院患者分别为0.980和0.686)。结论：本研究首次根据Espen对营养不良的新定义分析了营养不良筛查工具的临床价值。根据我们的结果，HAME与Espen定义营养不良的标准有更好的相关性，这使我们得出结论，在筛查过程中，它可以更有效地识别营养不良患者。(C)2016爱思唯尔有限公司和欧洲临床营养和代谢学会。版权所有。
Background: The new definition of malnutrition in adults proposed recently by The European Society for Clinical Nutrition and Metabolism (ESPEN) changed the view on the issue and raised the question of the reliability of available diagnostic tools. Therefore, the aim of this study was to verify the accuracy of the two most commonly used screening tools by comparing their findings with the new ESPEN criteria.Methods: Nutritional screening was performed in 1146 (median age 60 years, interquartile range: 44-73 years, 617 males, 529 females) patients on admission to hospitals with two nutritional screening tools: Nutritional Risk Screening 2002 (NRS2002) and Malnutrition Universal Screening Tool (MUST). The screening results were then compared to the ESPEN new diagnostic criteria for malnutrition.Results: According to the NRS2002 13.5% and 27.9% of the outpatients and hospitalized patients respectively were found to be at moderate/high risk of malnutrition. With the use of MUST 9.1% and 14.9% of the outpatients and hospitalized patients respectively were found to be at moderate/high risk of malnutrition. According to the ESPEN diagnostic criteria 6.4% and 11.3% of outpatients and hospitalized patients respectively were classified as malnourished. MUST was found to be better correlated to the latter for both outpatients (K = 0.777, p < 0.001) and hospitalized patients (K = 0.843, p < 0.001) as compared to NRS2002 (it = 0.256, p < 0.001 and k = 0.228, p < 0.001). ROC plots Area Under the Curve (AUC) was found to be higher for MUST compared to NRS2002 (0.964 vs. 0.695 for outpatients and 0.980 vs 0.686 for hospitalized patients respectively).Conclusion: To our knowledge, this study is the first to analyze the clinical value of a malnutrition screening tool in the light of the new ESPEN definition for malnutrition. According to our results, MUST was better correlated with ESPEN criteria for the definition of malnutrition, leading us to the conclusion that it can more efficiently identify the malnourished patients, during the screening process. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.