Beyond Malnutrition Screening: Appropriate Methods to Guide Nutrition Care for Aged Care Residents
Beyond Malnutrition Screening: Appropriate Methods to Guide Nutrition Care for Aged Care Residents
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DOI：
10.1016/j.jada.2011.09.038
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发表时间：
2012-03-01
影响因子：
4.8
通讯作者：
Bauer, Judith D.
中科院分区：
文献类型：
--
作者：
Isenring, Elisabeth A.;Banks, Merrilyn;Bauer, Judith D.
背景营养不良在老年人中很常见，早期和适当的营养干预可以导致积极的生活质量和健康outcome.Objective我们的研究目的是确定在长期护理环境中，几种营养不良筛查工具和人体测量参数与经验证的营养评估工具的同时有效性。观察性研究。参与者/设置老年人主要结果营养筛查工具包括营养不良筛查工具（MST）、营养不良通用筛查工具（MUST）、简易营养评估量表（MNA-SF）、和简化营养评估问卷。通过主观全面评估（SGA）、简易营养评估（MNA）、体重指数（BMI）、校正的手臂肌肉面积和小腿围来评估营养状况。结果127名居民中，营养筛查工具和客观指标与SGA和MNA相比，对营养状况的敏感性和特异性有显著性差异（P < 0. 05），营养筛查工具和客观指标与SGA和MNA相比，对营养状况的敏感性和特异性有显著性差异（P < 0. 05（31.5%男性;平均年龄82.7 ± 9岁，57.5%高度护理）同意。根据SGA，27.6%（n=31）的居民营养不良，13.4%被MNA评为营养不良。MST的敏感性和特异性最高，其次为SGA（敏感性88.6%，特异性93.5%，kappa=0.806）、MNA-SF（85.7%，62%，kappa=0.377）、MUST（68.6%，96.7%，kappa=0.703）和简化营养评估问卷（45.7%，77.2%，kappa=0.225）。与MNA相比，MNA-SF的敏感性最高，为100%，但特异性为56.4%（kappa=0.257）。MST与MNA比较，敏感性为94.1%，特异性为80.9%（kappa=0.501）。与SGA和MNA相比，人体测量屏幕的kappa值范围为0.193至0.468。结论MST、MUST、MNA-SF和人体测量屏幕校正的手臂肌肉面积和小腿围与经验证的营养评估工具相比具有可接受的同时有效性，可用于长期护理环境中的营养护理分诊。Acad Nutr Diet. 2012;112：376-381.
Background Malnutrition is common in older adults and early and appropriate nutrition intervention can lead to positive quality of life and health outcomes.Objective The purpose of our study was to determine the concurrent validity of several malnutrition screening tools and anthropometric parameters against validated nutrition assessment tools in the long-term-care setting.Study design This work was a cross-sectional, observational study.Participants/setting Older adults (aged >55 years) from two long-term-care facilities were screened.Main outcomes Nutrition screening tools used included the Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Simplified Nutritional Assessment Questionnaire. Nutritional status was assessed by Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), corrected arm muscle area, and calf circumference. Residents were rated as either well nourished or malnourished according to each nutrition assessment tool.Statistical analysis A contingency table was used to determine the sensitivity and specificity of the nutrition screening tools and objective measures in detecting patients at risk of malnutrition compared with the SGA and MNA.Results One hundred twenty-seven residents (31.5% men; mean age 82.7 +/- 9 years, 57.5% high care) consented. According to SGA, 27.6% (n=31) of residents were malnourished and 13.4% were rated as malnourished by MNA. MST had the best sensitivity and specificity compared with the SGA (sensitivity 88.6%, specificity 93.5%, kappa=0.806), followed by MNA-SF (85.7%, 62%, kappa=0.377), MUST (68.6%, 96.7%, kappa=0.703), and Simplified Nutritional Assessment Questionnaire (45.7%, 77.2%, kappa=0.225). Compared with MNA, MNA-SF had the highest sensitivity of 100%, but specificity was 56.4% (kappa=0.257). MST compared with MNA had a sensitivity of 94.1%, specificity 80.9% (kappa=0.501). The anthropometric screens ranged from kappa=0.193 to 0.468 when compared with SGA and MNA. Conclusions MST, MUST, MNA-SF, and the anthropometric screens corrected arm muscle area and calf circumference have acceptable concurrent validity compared with validated nutrition assessment tools and can be used to triage nutrition care in the long-term-care setting. Acad Nutr Diet. 2012;112:376-381.