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Comparison of Five Malnutrition Screening Tools in a Cohort of Acutely Ill Older Adults
Author(s) -
Deer Rachel R,
Volpi Elena
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1157.4
Subject(s) - malnutrition , medicine , cohort , pediatrics , cohort study
Over the last decades numerous nutrition screening tools have been developed. Currently there is no international consensus on a single ‘best tool’ to determine the prevalence of malnutrition in acutely ill older adults. We examined the prevalence of malnutrition in a cohort of older adults (>65 years) hospitalized on the Acute Care for Elders unit at UTMB using five commonly used screening tools: (Malnutrition Screen Tool (MST), Mini Nutritional Assessment Short Form (MNA‐SF), Subjective Global Assessment (SGA), Nutritional Risk Screening 2002 (NRS‐2002), and Malnutrition Universal Screening Tool (MUST)). These tools were compared to a pre‐set definition of malnutrition risk based on the presence of either BMI <20kg/m 2 or >5% unintentional weight loss in the last 6 months. For this analysis, nutritional status was scored as either “normal” or “at‐risk/malnourished.” The prevalence of malnutrition varied greatly depending on which nutritional assessment tool was used, indicating a vast difference in specificity and sensitivity of the tools. According to the pre‐set definition 25.7% of our cohort was at‐risk of malnutrition/malnourished. Using the five screening tools, the highest prevalence of subjects “at‐risk/malnourished” was obtained with MNA‐SF (74.3%), followed by NRS‐2002 (60.8%), SGA (55.4%), MUST (31.1%) and finally MST (21.6%). Sensitivity and negative predictive values was adequate in all five tools (>75%). MNA‐SF, NRS‐2002, and SGA had poor specificity and low positive predictive values (<55%). These preliminary data (n=74) from an ongoing study, indicate that malnutrition in acutely ill older adults varies greatly depending on which tool is used for diagnosis (21.6–74.3%). MST and MUST had acceptable sensitivity and specificity and would be appropriate screening tools to be used in acutely ill older adults. Further research is necessary to determine the most valid and practical nutritional screening tool for use in this specialized population. Support or Funding Information This study was supported by the Dairy Research Institute (1229) and the Claude D. Pepper OAIC (P30‐AG024832). 1 Accuracies of the nutrition screening tools.Sensitivity Specificity Positive Predictive Value Negative Predictive ValueMST 75% 88% 63% 93% MNA 100% 35% 35% 100% MUST 95% 91% 78% 98% NRS 100% 53% 42% 100% SGA 84% 55% 39% 91%Malnutrition Screen Tool (MST), Mini Nutritional Assessment Short Form (MNA‐SF), Subjective Global Assessment (SGA), Nutritional Risk Screening 2002 (NFS‐2002), and Malnutrition Universal Screening Tool (MUST)