scholarly journals Mini Nutritional Assessment predicts gait status and mortality 6 months after hip fracture

2012 ◽  
Vol 109 (9) ◽  
pp. 1657-1661 ◽  
Author(s):  
David N. Gumieiro ◽  
Bruna P. M. Rafacho ◽  
Andrea F. Gonçalves ◽  
Suzana E. Tanni ◽  
Paula S. Azevedo ◽  
...  

The aim of the present study was to evaluate the Mini Nutritional Assessment (MNA), the Nutritional Risk Screening (NRS) 2002 and the American Society of Anesthesiologists Physical Status Score (ASA) as predictors of gait status and mortality 6 months after hip fracture. A total of eighty-eight consecutive patients over the age of 65 years with hip fracture admitted to an orthopaedic unit were prospectively evaluated. Within the first 72 h of admission, each patient's characteristics were recorded, and the MNA, the NRS 2002 and the ASA were performed. Gait status and mortality were evaluated 6 months after hip fracture. Of the total patients, two were excluded because of pathological fractures. The remaining eighty-six patients (aged 80·2 (sd 7·3) years) were studied. Among these patients 76·7 % were female, 69·8 % walked with or without support and 12·8 % died 6 months after the fracture. In a multivariate analysis, only the MNA was associated with gait status 6 months after hip fracture (OR 0·773, 95 % CI 0·663, 0·901; P= 0·001). In the Cox regression model, only the MNA was associated with mortality 6 months after hip fracture (hazard ratio 0·869, 95 % CI 0·757, 0·998; P= 0·04). In conclusion, the MNA best predicts gait status and mortality 6 months after hip fracture. These results suggest that the MNA should be included in the clinical stratification of patients with hip fracture to identify and treat malnutrition in order to improve the outcomes.

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1306 ◽  
Author(s):  
Julia Traub ◽  
Ina Bergheim ◽  
Angela Horvath ◽  
Vanessa Stadlbauer

Malnutrition in liver cirrhosis is frequently underestimated. To determine if a patient is at risk of malnutrition, several screening tools have been established. However, most of them are not validated for patients with liver cirrhosis. Therefore, we compared the RFH-NPT (Royal Free Hospital Nutritional Prioritizing Tool) as the validated gold standard for malnutrition screening in cirrhosis patients with GMS (Graz Malnutrition Screening), NRS-2002 (Nutritional Risk Screening) and MNA-SF (Mini Nutritional Assessment-Short Form). Based on common validity criteria for screening tools, only the MNA-SF showed fair correlation (12/15 points) with the RFH-NPT, whereas NRS-2002 and GMS performed worse (6/15 points). Taken together, our results suggest that NRS-2002 and GMS are not suitable for screening of malnutrition in cirrhosis patients. A cirrhosis-specific screening tool like RFH-NPT should be used to assess malnutrition and to identify those at risk of malnutrition.


2019 ◽  
Vol 1 (1) ◽  
pp. 89-97
Author(s):  
Géssica Camilo ◽  
Débora Regina Hendges Poletto Pappen

A desnutrição é algo comum em pacientes em estado crítico, tais como os internados em Unidades de Tratamento Intensivo (UTIs). Essa condição deve ser tratada rapidamente para que não ocorra um agravamento do estado clínico do paciente. Entretanto, a identificação de uma possível desnutrição em pacientes hospitalizados é, por vezes, imprecisa, dada a condição dos mesmos. Diversas ferramentas e sistemas já foram propostos na literatura para a triagem de pacientes, dentre eles destacam-se a Avaliação Nutricional Subjetiva Global (ANSG), a Mini Nutritional Assessment (MNA) e a Nutritional Risk Screening 2002 (NRS 2002). O objetivo deste trabalho é aplicar essas triagens em pacientes internados na UTI de um hospital do Oeste do Paraná e analisar os resultados para uma comparação entre as diferentes ferramentas e os grupos de pacientes (idosos e adultos). Os resultados da pesquisa mostram que pacientes idosos e adultos não apresentam uma diferença estatística no nível de desnutrição. Além disso, os resultados das três triagens foram em sua maior parte diferentes, não havendo diferença estatística apenas entre o ANSG e o NRS 2002 quando considerados todos os pacientes.


2014 ◽  
Vol 23 (01) ◽  
pp. 5-10
Author(s):  
E.C. Bliemel ◽  
R. Aigner ◽  
C. Rolfes ◽  
S. Ruchholtz ◽  
B. Buecking ◽  
...  

ZusammenfassungDie Inzidenz von Mangelernährung geriatrischer Patienten wird im Allgemeinen mit über 50 % angegeben. Mangelernährung bei geriatrischen Traumapatienten rangiert im Kollektiv der proximalen Femurfrakturen zwischen 30 und 50 %. Insgesamt erscheinen sowohl die angegebenen Häufigkeiten als auch die angewandten Messinstrumente inhomogen. Malnutrition führt zu einer Verschlechterung der Wundheilung, einer längeren postoperativen Immobilität, einem verlängerten Krankenhausaufenthalt sowie zu einer Steigerung der Mortalität. Unter Hinzuziehung bestehender Leitlinien erreichen das Mini Nutritional Assessment (MNA) sowie das Nutritional Risk Screening (NRS) eine ausreichende prädiktive Validität in diesem geriatrischen Patientengut, um ein Screening auf Mangelernährung durchzuführen. Bezüglich möglicher therapeutischer Interventionen ist die Studienlage limitiert: Vorhandene Studien zeigen oft eine geringe Patientenzahl und demente Patienten, die besonders häufig mangelernährt sind, wurden häufig ausgeschlossen. Eine Leitlinie explizit für dieses spezielle Patientengut existiert aktuell nicht. Ein suffizientes Screening des Ernährungszustandes sowie Daten zur Durchführbarkeit und Effizienz einer kurzfristigen perioperativen Nahrungsergänzung könnten einen wichtigen Beitrag zur Stabilisierung dieser oft multimorbiden und fragilen Patienten leisten.


2019 ◽  
Vol 56 (4) ◽  
pp. 447-450 ◽  
Author(s):  
Vânia Aparecida LEANDRO-MERHI ◽  
Caroline Lobo COSTA ◽  
Laiz SARAGIOTTO ◽  
José Luiz Braga de AQUINO

ABSTRACT BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher’s exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.


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