Accurate diagnosis of an institutional nutritional screening scale
DOI:
https://doi.org/10.17533/udea.penh.18997Keywords:
malnutrition, hospitalization, patient care, nutrition assessment, ROC curve, strainingAbstract
Introduction: subjective global assessment (SGA) is a method included in nutritional assessment. However, it is required to make an adjustment to reduce subjectivity in nutritional risk assessment. Objective: To determine the diagnostic accuracy of an institutional scale for nutritional screening from a third/fourth level hospital. Methods: 310 patients were participated in a cross-sectional study. Each patient was evaluated by SGA and institutional scale. Diagnostic accuracy was evaluated by sensitivity, specificity, positive predictive value, negative predictive value and area under a ROC curve (AUC). Results: Undernutrition risk and undernutrition, evaluated by SGA, were 47.1% and 15.8%, respectively. In contrast, undernutrition risk and undernutrition, evaluated by the institutional scale, were respectively: 39.4% and 15.2%. Institutional scale sensitivity to detect nutritional risk and undernutrition was 75.4%. The ROC curve indicated an acceptable level of discrimination AUC: 0.78 (IC 95% 0.73-0.84). Conclusion: compared to the SGA, the institutional scale has an acceptable accuracy diagnosis to evaluate nutritional status. Thus, it is a practical and safe tool, in hospitalized adult patients, in order to indicate appropriate therapeutic interventions.
Downloads
References
Correia MI, Campos AC. ELAN Cooperative study: prevalence of hospital malnutrition in Latin America: The Multicenter ELAN Study. Nutrition. 2003;19:823-5.
Waitzberg DL, Caiaffa W, Correia MI. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4.000 patients. Nutrition. 2001;17:573-80.
Waitzberg DL, Gama-Rodrigues J, Correia MI. Desnutrição hospitalar no Brasil. In: Waitzberg DL. Nutrição oral, enteral e parenteral na prática clínica. 3 ed. São Paulo: Atheneu; 2000. p.385-97.
Lobo Taner G, Ruiz López MD, Pérez de la Cruz AJ. Desnutrición hospitalaria: relación con la estancia media y la tasa de reingresos prematuros. Med Clin. 2009;132:377-64.
Ulíbarri JI, González A, González P. Nuevo procedimiento para la detección precoz y control de la desnutrición hospitalaria. Nutr Hosp. 2002;17:179-88.
Ulibarri JI, Burgos R, Lobo G. Recomendaciones sobre la evaluación del riesgo de desnutrición en los pacientes hospitalizados. Nutr Hosp. 2009;24:467-72.
Lesourd B. Nutrition: a major factor influencing immunity in the elderly. J Nutr Health Aging. 2004;8:28-37.
Sullivan D, Bopp M, Roberson P. Protein-energy undernutrition and life threatening complications among hospital elderly. J Gen Intern Med. 2002;17:923-32.
Reilli J, Hull S, Albert N, Walter A, Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. Parent Enter Nutr. 1988;12:371-6.
Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22:235-9.
Norman K, Richard C, Lochs H, Pirlich M. Prognostic impact of disease –related malnutrition. Clin Nutr. 2008;27:5-15.
Müller O, Krawinkel M. Malnutrition and health in developing countries. Can Med Assoc J. 2005;173:279-86.
Council of Europe. Committee of Ministers. Resolution ResAP (2003) on food and nutritional care in hospitals. Bruxeles: 2003.
Odelli C, Burgess D, Baterman. Nutrition support improves patient outcomes, treatment tolerance and admission characteristics in patients in esophageal cancer. Clin Oncol (R Coll Radiol). 2005;17:639-45.
Babineau J, Villalon L, Laporte M, Payette H. Outcomes of screening and nutritional intervention among older adults in healthcare facilities. Can J Diet Pract Res. 2008;69:89-94.
Villamayor L, Llimera G, Vidal VL. Valoración nutricional al ingreso hospitalario: iniciación al estudio entre distintas metodologías. Nutr Hosp. 2012;27:701-6.
Álvarez J. Del Río M. Planas. Documento SENPE-SEDOM sobre la codificación de la desnutrición hospitalaria. Nutr Hosp. 2008;23:536-54.
Soeters P, Reijven P, Van Bokhorst-de van der Shueren MA, Schols J, Halfens R, Meijers J, et al. A rational approach to nutritional assessment. Clin Nutr. 2008;27:706-16.
Pérez de la Cruz A, Lobo Támer G, Orduña Espinosa R, Mellado Pastor C, Aguayo de Hoyos E, Ruiz López MD. Malnutrition in hospitalized patients: prevalence and economic impact. Med Clin. 2004;123:201-6.
Raja R, Lim AV, Lim P, Chan P, Vu CK. Malnutrition screening in hospitalized patients and its implication on reimbursement. Intern Med J. 2004;34:176-81.
Rasmussen HH, Holst M, Kondrup J. Measuring nutritional risk in hospitals. Clin Epidemiol. 2010;2:209-16.
García A, Álvarez J, Calvo MV. Conclusiones del II Foro de Debate SENPE sobre desnutrición hospitalaria. Nutr Hosp. 2005;20:82-7.
Detsky AS, Baker JP, Mendelson RA. Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparison. J Parenter Enteral Nutr. 1984;8:153-9.
Ocón MJ, Altemir Jl. Comparación de dos herramientas de cribado nutricional para predecir la aparición de complicaciones en pacientes hospitalizados. Nutr Hosp. 2012;27:701-6.
Hensrud D. Nutrition screening and assessment. Med Clin North Am. 1999;83:1525-46.
Detsky AS, Mc Laughin JR, Baker JP. What is subjective global assessment of nutritional status? J Parenter Enteral Nutr. 1987;11:8-13.
Raslan M, González MC, Torrinhas RS. Complementarily of subjective global assessment (SGA) and nutritional risk screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. Clin Nutr. 2011;30:49-53.
Baker JP, Detsky AS, Wesson DA. Nutritional assessment: a comparison of clinical judgement and objective measurements. N Engl J Med. 1982;306:969-72.
Ulíbarri JI. La desnutrición hospitalaria. Nutr Hosp. 2003;18:53-6.
Parvin M, Somayeh M, Homeira M. Validity and reliability of a nutrition screening tool in hospitalized patients. Nutrition. 2011;27:647-52.
Hoyos S, Giraldo N, Henao K, Muñoz N, Restrepo MV, Saldarriaga N. Valoración global subjetiva no solamente como tamizaje. Lect Nutr. 2000;7:56-62.
Colombia. Ministerio de Salud. Resolución número 008430, de octubre de 1993. [citado abril de 2013]. Disponible en http://issuu.com/scpbogota/docs/resolucion_8430.
Waitzberg DL, Ravacci GR, Raslan M. Desnutrición hospitalaria. Nutr Hosp. 2011;26:254-64.
Hafsteinsdottir TB, Mosselman M, Schoneveld C. Malnutrition in hospitalized neurological patients approximately doubles in 10 days of hospitalization. J Clin Nurs. 2010;19:639-48.
Blackburn GL, Bistrian BR, Maini BS. Nutritional and metabolic assessment of the hospitalized patients. J Parenter Enteral Nutr. 1977;1:11-22.
Ulibarri JI, Picón MJ, García E, Mancha A. Detección precoz y control de la desnutrición hospitalaria. Nutr Hosp. 2002;17:139-46.
Giraldo NA, Múnera NE, Marrugo V, Piñeres LM. Prevalencia de malnutrición y evaluación de la prescripción dietética en pacientes adultos hospitalizados en una institución pública de alta complejidad. Persp Nutr Humana. 2007;9:37-47.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. Guidelines for nutrition screening 2002: European Society of Parenteral and Enteral Nutrition (ESPEN). Clin Nutr. 2003;22:415-21.
Valero MA, Díez L, El Kadaoui N, Jiménez AE, Rodríguez H, León M. ¿Son las herramientas recomendadas por la ASPEN y la ESPEN equiparables en la valoración del estado nutricional? Nutr Hosp. 2005;20:259-67.
Kondrup J, Rasmussen H, Hamberg O, Stanga Z. ESPEN working Group. Nutritional risk screening (NRS 2002): a new method based on analysis of controlled clinical trials. Clin Nutr. 2003;22:321-6.
Fernández C, González I, Antolín Juárez FM, García P. Detección de malnutrición al ingreso en el hospital. Nutr Hosp. 2003;18:95-100.
Kruizenga HM, Seidell JC, de Vet HC, Wierdsma NJ, van Bokhorst-de van der Schueren MA. Development and validation of a hospital screening tool for malnutrition: the short nutritional assessment questionnaire (SNAQ). Clin Nutr. 2005;24:75-82.
Rabat JM, Campos C, Polo J, Maraver S. Estudio comparativo entre malnutrition universal screening tool (MUST) y valoración global subjetiva (VGS) en una población adulta al ingreso hospitalario. Trabajo presentado en el Congreso Nacional de la Sociedad Española de Endocrinología y Nutrición, 2008, Endocrinol Nutr. 2008;55(Supl 5):1-145.
Zwenger Y, Salinas S,Cicchitti A, Pool MC y Russo A. Herramientas de screening nutricional. Buenos Aires: Asociación Argentina de Nutrición Enteral y Parenteral; 2011.
Lim SL, Tong CY, Ang E, Lee EJ, Loke WC, Chen Y, et al. Development and validation of 3-Minute Nutrition Screening (3-MinNS) tool for acute hospital patients in Singapore. Asia Pac J Clin Nutr. 2009;18:395-403.
Downloads
Published
How to Cite
Issue
Section
License
Derechos de autor 2024 Universidad de Antioquia
