Feasibility of using the “modified NUTrition Risk In the Critically ill” nutritional risk screening tool to identify nutritionally at-risk patients in an Australian intensive care unit

2020 ◽  
Vol 33 (3) ◽  
pp. 259-263 ◽  
Author(s):  
Sean Kenworthy ◽  
Ekta Agarwal ◽  
Lisa Farlow ◽  
Rebecca Angus ◽  
Andrea P. Marshall
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Intensive Care ◽  
Critically Ill ◽  
Screening Tool ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Nutrition Risk ◽  
Risk Patients ◽  
Nutritional Risk Screening

scholarly journals Feasibility of using the mnutric nutritional risk screening tool to identify nutritionally at-risk patients in an Australian ICU

2020 ◽  
Vol 33 ◽  
pp. S9
Author(s):  
Lisa Mahoney ◽  
Sean Kenworthy ◽  
Rebecca Angus ◽  
Ekta Agarwal ◽  
Andrea P. Marshall
Keyword(s):  
At Risk ◽  
Screening Tool ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Risk Patients ◽  
Nutritional Risk Screening

scholarly journals Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: a secondary analysis of a large prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Wang ◽  
Mei-Ping Wang ◽  
Li Jiang ◽  
Bin Du ◽  
Bo Zhu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Secondary Analysis ◽  
Nutritional Risk ◽  
Icu Patients ◽  
Nutrition Risk ◽  
Risk Patients ◽  
Youden’S Index

Abstract Background Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. The modified nutrition risk in the critically ill score (mNUTRIC) was proposed as an appropriate nutritional assessment tool in critically ill patients, but it has not been fully demonstrated and widely used. Our study was conducted to identify the nutritional risk in ICU patients using the mNUTRIC score and explore the relationship between 28-day mortality and high mNUTRIC scores. Methods This study is a secondary analysis, the data were extracted from The Beijing Acute Kidney Injury Trial (BAKIT). In total, 9049 patients were admitted consecutively, and 3107 patients with complete clinical data were included in this study. We divided the study population into high nutritional risk (mNUTRIC score ≥ 5 points) and low nutritional risk (mNUTRIC score < 5 points) groups. The predictive capacity of the mNUTRIC score was studied by receiver operating characteristic (ROC) curve analysis, appropriate cut-off was identified by highest combined sensitivity and specificity using Youden’s index. The significance level was set at 5%. Results Among the 3107 patients, the 28-day mortality rate was 17.4% (540 patients died). Nearly 28.2% of patients admitted to the ICU were at risk of malnutrition, high nutritional risk patients were older (P < 0.001), with higher illness severity scores than low nutritional risk patients. Multivariate analysis revealed that the mNUTRIC score was an independent risk factor for 28-day mortality and mortality increased with increasing scores (p = 0.000). The calculated area under curve (AUC) for the mNUTRIC score was 0.763 (CI 0.740–0.786). According to Youden’s index, we found a suitable cut-off > 4 for the mNUTRIC score to predict the 28-day mortality. Conclusions Patients admitted to the ICU were at high risk of malnutrition, and a high mNUTRIC score was associated with increased ICU length of stay and higher mortality. More large prospective studies are needed to demonstrate the validity of this score. Trial registration This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875). Registered on 14 December 2011.

scholarly journals Association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score and clinical outcomes in the intensive care unit: A secondary analysis of a large prospective observational study

2021 ◽  
Author(s):  
Na Wang ◽  
Mei-Ping Wang ◽  
Li Jiang ◽  
Bin Du ◽  
Bo Zhu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Prospective Observational Study ◽  
Nutritional Risk ◽  
Icu Patients ◽  
Nutrition Risk ◽  
Risk Patients

Abstract Background: Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. The nutrition risk in the critically ill score (NUTRIC) was proposed as an appropriate nutritional assessment tool in critically ill patients. This score uses interleukin-6 (IL-6), a biomarker that is not always available. This prospective observational study was conducted to identify the nutritional risk in ICU patients using the modified NUTRIC (mNUTRIC) score (which does not include IL-6) and to explore the relationship between 28-day mortality and high mNUTRIC scores.Methods: The data were extracted from The Beijing Acute Kidney Injury Trial (BAKIT). This trial was a prospective, observational, multi-centre study conducted in 30 ICUs at 28 tertiary hospitals in Beijing, China, from March 1 to August 31, 2012. In total, 9049 patients were admitted consecutively, and 3107 patients with complete clinical data were included in this study. The predictive capacity of the mNUTRIC score was studied by receiver operating characteristic (ROC) curve analysis. The significance level was set at 5%.Results: Among the 3107 patients, the 28-day mortality rate was 17.4% (540 patients died). High nutritional risk patients were older (P<0.001), with higher illness severity scores than low nutritional risk patients. Multivariate analysis revealed that the mNUTRIC score was an independent risk factor for 28-day mortality and mortality increased with increasing scores (p = 0.000). The calculated area under curve (AUC) for the mNUTRIC score was 0.763 (CI 0.740 - 0.786).Conclusions: Nearly 28.2% of patients admitted to the ICU were at risk of malnutrition, and a high mNUTRIC score was associated with increased ICU length of stay and higher mortality.Trial Registration: This study was registered at www.chictr.org.cn (registration number Chi CTR-ONC-11001875). Registered on 14 December 2011.Key words:The modified nutrition risk in critically ill score, Intensive care unit, Mortality

scholarly journals Development and Validation of Self-screening Tool for Nutrition Risk in Patients With Gastric Cancer After Gastrectomy: A STUDY PROTOCOL

2021 ◽  
Author(s):  
Zhiming Chen ◽  
Haichi Yu ◽  
Hua Yuan ◽  
Jia Wang ◽  
Qiuchen Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Screening Tool ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Health Measurement ◽  
Risk Screening ◽  
Nutrition Risk ◽  
Verification Methods ◽  
Nutritional Risk Screening ◽  
At Home

Abstract Background: The incidence of malnutrition in patients with gastric cancer after surgery is 59%. The main reason for the high incidence of malnutrition is untimely nutrition screening and low compliance with nutrition treatment. In order to enable home patients to know their nutritional status in time, we have developed and validated nutritional risk screening tools for patients with gastric cancer to help patients’ at home find nutritional risks in time and seek medical help. This article introduces the development and verification methods and statistical methods of the tool.Methods: The development of self-nutrition risk screening tool for patients with gastric cancer after gastrectomy (SNRSGC) is divided into four parts：Steps1Identification of a potential referred nutritional risk screening; Steps2Item generation and scoring are selected through literature review methods to screen sensitive indicators that can reflect the nutritional characteristics of patients after gastric cancer surgery, establish the frame and update according to the latest guidelines ；Steps3Item reduction is determined by the rating of SNRSGC items by an expert panel and piloting method to determine the final item; Steps4 In the validation stage, we conducted research design based on the Consensus-based Standards for the selection of health Measurement Instruments checklist to evaluate the content validity, structure validity, interpretability, and retest validity of SNRSGC.Discussion: SNRSGC is the first screening tool specifically to predict nutrition risk for stay-at-home postoperative patients with gastric cancer.SNRSGC may provide action guidelines and knowledge guidance for patients with gastric cancer at home.Trial registration: Identifier on Chinese Clinical Trials Registry : ChiCTR2100041809 , registered January 06, 2021.

scholarly journals Identifying Malnutrition in a Low-Resource Clinical Setting: Evaluation of a Nutrition Risk Screening Tool in Lao PDR

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1121-1121
Author(s):  
Joanna Cummings ◽  
Hannah Wilson ◽  
Diane Stadler
Keyword(s):  
At Risk ◽  
Low Income ◽  
Screening Tool ◽  
Lao Pdr ◽  
Nutritional Risk ◽  
Operating Characteristics ◽  
Risk Screening ◽  
Nutrition Risk ◽  
Low Resource ◽  
Significant Difference

Abstract Objectives The aim of this study was to investigate the inter-user reliability and validity of a nutritional risk screening tool (NRST) used to identify patients at-risk for malnutrition. The screening tool was designed for use in Lao PDR, a low-income, low-resource country in Southeast Asia. Methods A cross-sectional study was conducted between August - September 2018 and enrolled newly admitted patients to two national hospitals in Vientiane, Lao PDR. The screening tool consisted of 4 items: 1) subjective clinical assessment, 2) presence of high-risk disease, 3) adequacy of nutritional intake, 4) weight loss history. The Academy/ASPEN consensus on acute and chronic malnutrition indicators were used to make a diagnosis of malnutrition. Cohen's Kappa Coefficient (k) was calculated to determine inter-user reliability. Validity was determined using sensitivity, specificity, and area-under-the-receiver-operating-characteristics (AUC-ROC) curve analyses. Results 194 patients met inclusion criteria for this study. The median adult age was 43 years; the median pediatric age was 8 years. Of adults screened, 56% were classified as “at risk for” or “met” criteria for malnutrition. Among children 0–4 years of age, 51% met criteria for malnutrition, whereas among those 5–17 years of age, 58% met criteria for malnutrition. The inter-user reliability of the NRST was significant with a fair k of 0.27 ± 0.03 (p = &lt; 0.0001). The NRST had a sensitivity of 85% and a specificity of 35%. There was no significant difference in the probability of correctly identifying a malnourished patient when comparing trained and untrained observer scores (AUC-ROC of 0.70 and 0.64, respectively; P &gt; 0.05). Conclusions This data suggests a high prevalence of malnutrition among recently admitted hospitalized patients in Lao PDR and reinforces the need for a tool to identify risk of malnutrition. The results also indicate that implementing a nutrition risk screening tool within national hospitals in Lao PDR is feasible. Funding Sources Funding provided by OHSU Foundation, Vejdusit Foundation and Bangkok Dusit Medical Systems.

scholarly journals New screening tool for neonatal nutritional risk in China: a validation study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042467
Author(s):  
Mei Zhou ◽  
Yuwei Li ◽  
Huaying Yin ◽  
Xianhong Zhang ◽  
Yan Hu
Keyword(s):  
Validation Study ◽  
Head Circumference ◽  
Predictive Value ◽  
Screening Tool ◽  
Nutritional Risk ◽  
Risk Level ◽  
Spearman Correlation ◽  
Nutrition Risk ◽  
Sensitivity Specificity ◽  
Nutritional Risk Screening

ObjectiveA neonatal nutritional risk screening tool (NNRST) was developed by using Delphi and analytic hierarchy processes in China. We verified the accuracy of this tool and analysed whether it effectively screened neonates with nutritional risk.DesignProspective validation study.Setting and participantsIn total, 338 neonates who were admitted to the neonatal unit of Children’s Hospital of Chongqing Medical University from May–July 2016 completed the study. Nutritional risk screening and length and head circumference measurements were performed weekly. Weight was measured every morning, and other relevant clinical data were recorded during hospitalisation.Main outcome measuresWe evaluated the sensitivity, specificity, validity, reliability, and positive and negative predictive value of the screening tool. Various characteristics of neonates in different risk groups were analysed to determine the rationality of the nutritional risk classification.ResultsThe sensitivity, specificity, and positive and negative predictive values were 85.11%, 91.07%, 60.61% and 97.43%, respectively. The criterion validity was texted by the Spearman correlation analysis (r=0.530) and independent samples non-parametric tests (p=0.000). The content validity (Spearman correlation coefficient) was 0.321–0.735. The inter-rater reliability (kappa value) was 0.890. Among the neonatal clinical indicators, gestational age, birth weight, length, admission head circumference, admission albumin, admission total proteins, discharge weight, discharge length and head circumference decreased with increasing nutrition risk level; the length of stay and the rate of parenteral nutrition support increased with increasing nutrition risk level. In the comparison of complications during hospitalisation, the incidence of necrotising enterocolitis and congenital gastrointestinal malformation increased with increasing nutrition risk level.ConclusionThe validation results for the NNRST are reliable. The tool can be used to preliminarily determine the degree of neonatal nutritional risk, but its predictive value needs to be determined in future large-sample studies.Trial registration numberChiCTR2000033743.

Sign in / Sign up

Export Citation Format

Share Document