Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the 'malnutrition universal screening tool' ('MUST') for adults
Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the 'malnutrition universal screening tool' ('MUST') for adults
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DOI：
10.1079/bjn20041258
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发表时间：
2004-11-01
影响因子：
3.6
通讯作者：
Elia, M
中科院分区：
文献类型：
--
作者：
Stratton, RJ;Hackston, A;Elia, M
已为所有卫生保健机构和患者群体开发了针对成年人的“营养不良通用筛查工具”(“必须”)，但在筛查以确定营养不良时，是否易于使用并与其他已公布的工具保持一致还需要进行调查。本研究评估了同一患者中“必须”和各种其他工具之间的一致性和营养不良风险的流行率，并比较了这些工具的易用性。使用“必须”和：(1)merec Bullett(MEREC)和Hickson and Hill(HH)工具(50名胃肠病门诊患者)；(2)营养风险评分(NRS)和营养不良筛查工具(MST；75名内科住院患者)；(3)简明微型营养评估(MNA-Tool；86名老年和85名外科住院患者)；(4)主观全面评估(SGA；50名内科住院患者)；(5)Doyle营养不良风险评分(URS；52名外科住院患者)。按“必须”计算，住院患者营养不良风险的患病率为19-60%，门诊患者为30%。“必须”与MEREC、NRS和SGA工具达成了“优秀”协议(kappa 0.775-0.893)，与HH、MST和MNA工具达成了“相当好”协议(kappa 0.551-0.711)，与URS工具达成了“差”协议(kappa 0.255)。当营养不良风险的分类因工具不同而不同时，除了“必须”和MNA-Tool(P=0.0005)和URS(P=0.039)之外，没有系统地进行分类。“必须”和MST是最容易、最快完成的工具(3-5分钟)。目前的调查表明，住院患者和门诊患者中营养不良的发生率很高(19-60%的人是“必须”)，而且“一般”到“极好”的一致性超出了“必须”和大多数其他研究工具之间的可能性。“必须”在这些患者群体中使用起来又快又容易。
The 'malnutrition universal screening tool' ('MUST') for adults has been developed for all health care settings and patient groups, but ease of use and agreement with other published tools when screening to identify malnutrition requires investigation. The present study assessed the agreement and the prevalence of malnutrition risk between 'MUST' and a variety of other tools in the same patients and compared the ease of using these tools. Groups of patients were consecutively screened using 'MUST' and: (1) MEREC Bulletin (MEREC) and Hickson and Hill (HH) tools (fifty gastroenterology outpatients); (2) nutrition risk score (NRS) and malnutrition screening tool (MST; seventy-five medical inpatients); (3) short-form mini nutritional assessment (MNA-tool; eighty-six elderly and eighty-five surgical inpatients); (4) subjective global assessment (SGA; fifty medical inpatients); (5) Doyle undernutrition risk score (URS; fifty-two surgical inpatients). Using 'MUST', the prevalence of malnutrition risk ranged from 19-60 % in inpatients and 30 % in outpatients. 'MUST' had 'excellent' agreement (kappa 0.775-0.893) with MEREC, NRS and SGA tools, 'fair-good' agreement (kappa 0.551-0.711) with HH, MST and MNA-tool tools and 'poor' agreement with the URS tool (kappa 0.255). When categorisation of malnutrition risk differed between tools, it did not do so systematically, except between 'MUST' and MNA-tool (P=0.0005) and URS (P=0.039). 'MUST' and MST were the easiest, quickest tools to complete (3-5 min). The present investigation suggested a high prevalence of malnutrition in hospital inpatients and outpatients (19-60 % with 'MUST') and 'fair-good' to 'excellent' agreement beyond chance between 'MUST' and most other tools studied. 'MUST' was quick and easy to use in these patient groups.