Can the Nutritional Risk Screening (NRS-2002) predict unfavorable clinical outcome in hospitalized elderly patients?

Background: Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics.Methods: The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia.Results: Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 � 1.0, with a percentage weight loss history of 11.7% � 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 � 0.7 versus 4.8 � 1.1 (P = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (P = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; P = 0.034 versus 0.584; P = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; P = 0.009), the increase in glucose concentrations (cc = 0.600; P < 0.001), and the decrease in erythrocyte counts (cc = -0.520; P = 0.001) during the colder season.Conclusion: Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment.

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Comparison of Malnutrition Screening Tools for Use in Hospitalized Older Adults (OR36-02-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz035.or36-02-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Rachel Deer ◽

Mackenzie McCall ◽

Elena Volpi

Keyword(s):

Older Adults ◽

Elderly Patients ◽

Screening Tool ◽

Screening Tools ◽

Good Sensitivity ◽

Predictive Values ◽

Hospitalized Elderly ◽

Nrs 2002 ◽

Hospitalized Elderly Patients ◽

Hospitalized Older Adults

Abstract Objectives Malnutrition is a common problem in geriatric patients that often goes unrecognized. Undernutrition is a primary health concern for older adults due to associations with increased mortality, complications, and length of hospital stay. Yet, there is no consensus on which malnutrition screening tool should be used for hospitalized older adults. Therefore, the objective of this study was to determine which screening tool is best to rapidly detect malnutrition in hospitalized older adults so that patient outcomes may be improved. Methods Older adult patients (n = 211; ≥65 yrs old) were enrolled during acute hospitalization. Testing occurring within 72 hours of admission and included the following screening tools included: Malnutrition Screening Tool (MST), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Geriatric Nutritional Risk Index (GNRI). These screening tools were compared to a malnutrition diagnostic tool, the Subjective Global Assessment (SGA). Results According to SGA, 49% of patients were at risk of being malnourished. The other screening tools indicated a wide range of malnutrition prevalence, from 18% (MST) to 76% (MNA-SF). MST (93%) and MUST (92%) were highest in sensitivity. NRS-2002 had moderately good sensitivity (71%). MNA-SF and GNRI had poor sensitivity, eliminating them as good screening tools for hospitalized elderly patients. Of the remaining tools, NRS-2002 had the highest specificity (77%). MST and MUST had poor specificity (31%, 39%, respectively), eliminating them as good screening tools for hospitalized elderly patients. The remaining screening tool, NRS-2002, had moderately good positive and negative predictive values (76%, 72%, respectively). It also had the highest kappa (0.479). Overall, NRS-2002 had the best agreement to SGA and showed moderately good sensitivity, specificity and predictive values. Conclusions Our data suggests NRS-2002 is the best malnutrition screening tool for rapid detection of malnutrition in elderly hospitalized patients, when compared to the diagnostic tool, SGA. Future research is needed to determine which screening tool is most effective for use in different settings. Additional research can assist in standardizing malnutrition criteria and care processes. Funding Sources National Dairy Council, National Institutes of Health-National Center for Advancing Translational Sciences, and UTMB Claude D. Pepper OAIC. Supporting Tables, Images and/or Graphs

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Complementarity of nutritional risk screening 2002 (NRS 2002), Patient-generated subjective global assessment (PG-SGA) and multiple nutritional indicators for predicting prognosis in patients undergoing radical gastrectomy for gastric cancer

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.09.245 ◽

2020 ◽

Vol 40 ◽

pp. 487-488

Author(s):

X. Bian

Keyword(s):

Gastric Cancer ◽

Global Assessment ◽

Nutritional Risk ◽

Radical Gastrectomy ◽

Subjective Global Assessment ◽

Risk Screening ◽

Nrs 2002 ◽

Nutritional Risk Screening 2002 ◽

Nutritional Risk Screening

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EuroOOPS: An international, multicentre study to implement nutritional risk screening and evaluate clinical outcome

Clinical Nutrition ◽

10.1016/j.clnu.2008.03.012 ◽

2008 ◽

Vol 27 (3) ◽

pp. 340-349 ◽

Cited By ~ 259

Author(s):

Janice Sorensen ◽

Jens Kondrup ◽

Jacek Prokopowicz ◽

Marc Schiesser ◽

Lukas Krähenbühl ◽

...

Keyword(s):

Clinical Outcome ◽

Multicentre Study ◽

Nutritional Risk ◽

Risk Screening ◽

Nutritional Risk Screening

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Comparação dos critérios da nrs-2002 com o risco nutricional em pacientes hospitalizados

Ciência & Saúde Coletiva ◽

10.1590/1413-81232018249.25042017 ◽

2019 ◽

Vol 24 (9) ◽

pp. 3325-3334

Author(s):

Adriana Aparecida de Oliveira Barbosa ◽

Andréa Pereira Vicentini ◽

Fernanda Ramos Langa

Keyword(s):

Nutritional Risk ◽

Risk Screening ◽

Nrs 2002 ◽

Para Determinar ◽

Nutritional Risk Screening

Resumo A triagem “Nutritional Risk Screening (NRS-2002)” é uma ferramenta considerada padrão ouro na análise do risco nutricional. Sendo assim, objetivou-se identificar na “NRS-2002” qual ou quais os critérios avaliados que mais contribuem para determinar o risco nutricional. Estudo descritivo transversal e quantitativo com 763 adultos e idosos hospitalizados, no ano de 2015. Aplicada a “NRS-2002” que avalia as variáveis Índice de Massa Corporal (IMC), perda de peso nos últimos 3 meses, redução da ingestão alimentar na última semana e gravidade da doença. A estatística dos dados foi descritiva e analítica por meio do método de regressão logística univariada. Observou-se que 46,4% dos pacientes apresentaram risco nutricional, com maiores chances em homens e idosos. Sendo a perda de peso o critério mais prevalente seguido da redução da ingestão alimentar, o IMC < 20,5kg/m² teve maior efeito no risco nutricional (OR = 31,0; IC 95%:14,21;67,44). Concluiu-se que o IMC < 20,5kg/m² e a perda de peso nos últimos três meses foram os fatores que mais contribuíram na determinação do risco nutricional, sendo a identificação precoce do risco nutricional de extrema importância para o direcionamento da conduta dietoterápica para a melhora da ingestão alimentar com objetivo de recuperação do peso corporal.

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