An alternative short-form Mini-Nutritional Assessment for rating the risk of malnutrition in persons on haemodialysis.
An alternative short-form Mini-Nutritional Assessment for rating the risk of malnutrition in persons on haemodialysis.
复制标题
另一种简短的迷你营养评估，用于评估血液透析患者营养不良的风险。
DOI：
10.1111/jocn.12037
复制
发表时间：
2013
影响因子：
4.2
通讯作者：
Meixiang Chang
中科院分区：
文献类型：
--
作者：
A. C. Tsai;Tsui;Meixiang Chang
宗旨和目标
改进简易营养评估（MNA），以改善对血液透析患者营养不良风险的低估。
背景
完整的MNA被认为是适当的评级接受血液透析的人营养不良的风险，但短期形式低估了风险。
设计
一项有目的抽样的横断面研究。
方法
该研究从台湾的一家透析中心招募了152名接受维持性血液透析的成人非卧床患者。每名受试者均采用主观整体评估（SGA）、台湾特定MNA（T1）的原始和选择的替代短表（通过将表现较好的非短表项目替换为表现较差的短表项目）进行评分。血清白蛋白和肌酐浓度以及SGA也用作参考。采用Pearson相关分析、二分类检验和受试者工作特征曲线（ROC）对结果进行评价。
结果
完整的MNA与SGA显示出良好的一致性，但与完整的MNA相比，最初的简表评估的营养不良风险患者较少。将项目O（自我评估的营养状况）与项目E（神经心理问题）交换产生了最好的结果，并恢复了简短形式的预测能力。将P项替换为E项产生了下一个最佳结果。
结论
结果表明，短期形式的预测能力可以大大恢复，通过重新安排的组成项目的短期形式，而不影响性能的完整的MNA。这项研究可能是针对特定疾病的多边核方案的第一个例子。
与临床实践的相关性
修订后的简易MNA适用于临床实践中对血液透析患者营养不良风险进行评级。
AIMS AND OBJECTIVES
To improve the short-form Mini-Nutritional Assessment (MNA) to ameliorate under-rating the risk of malnutrition in patients on haemodialysis.
BACKGROUND
The full MNA was found to be appropriate for rating the risk of malnutrition in persons undergoing haemodialysis but the short-form under-rated the risk.
DESIGN
A cross-sectional study with purposive sampling.
METHODS
The study recruited 152 adult ambulatory patients on maintenance haemodialysis from one dialysis centre in Taiwan. Each subject was rated with the Subjective Global Assessment (SGA), the original and selected alternative short-forms (by replacing better performing nonshort-form items for lesser performing short-form items) of a Taiwanese-specific MNA (T1). Serum albumin and creatinine concentrations and the SGA were also used as referents. Results were evaluated with Pearson's correlation analysis, binary classification test and receiver operating characteristic (ROC) curves.
RESULTS
The full MNA showed good consistency with the SGA, but the original short-form rated fewer patients at risk of malnutrition compared with the full MNA. Exchanging item O (self-rated nutritional status) with item E (neuropsychological problems) produced the best results and restored the predictive ability of the short-form. Replacing item P for E produced the next best results.
CONCLUSION
Results suggest that the predictive ability of the short-form can be greatly restored by rearranging the component items of the short-form without affecting the performance of the full MNA. The study is probably the first example of a disease-specific version of the MNA.
RELEVANCE TO CLINICAL PRACTICE
The revision makes short-form MNA suitable for rating the risk of malnutrition in patients on haemodialysis in clinical practice.