scholarly journals The relation between Malnutrition Universal Screening Tool (MUST), computed tomography–derived body composition, systemic inflammation, and clinical outcomes in patients undergoing surgery for colorectal cancer

2019 ◽  
Vol 110 (6) ◽  
pp. 1327-1334 ◽  
Author(s):  
Arwa S Almasaudi ◽  
Stephen T McSorley ◽  
Ross D Dolan ◽  
Christine A Edwards ◽  
Donald C McMillan
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Body Composition ◽  
Nutritional Status ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Universal Screening ◽  
Screening Tool ◽  
Length Of Hospital Stay ◽  
Malnutrition Universal Screening Tool

ABSTRACT Background Nutritional status is an important factor affecting a patient's clinical outcomes. Early identification of patients who are at risk of malnutrition is important to improve clinical outcomes and reduce health cost. The Malnutrition Universal Screening Tool (MUST) has been recommended as part of the routine nursing assessment for all patients at hospital admission. Objective The aim of this study was to examine the association between nutritional status (MUST), systemic inflammatory response (SIR), body composition, and clinical outcomes in patients undergoing surgery for colorectal cancer. Methods The malnutrition risk was examined using MUST in patients admitted for surgery for colorectal cancer between March 2013 and June 2016. Preoperative computed tomography scans were used to define the body composition. The presence of SIR was evidenced by the modified Glasgow prognostic score and the neutrophil to lymphocyte ratio. Postoperative complications, severity of complication, length of hospital stay, and mortality were considered as outcome measures. Results The study included 363 patients (199 males, 164 females); 21% of the patients presented with a medium or high nutritional risk. There were significant associations between MUST and subcutaneous adiposity (P < 0.001), visceral obesity (P < 0.001), and low skeletal muscle index (P < 0.001). No statistically significant association was identified between MUST score and presence of any complication or severity of complication. On multivariate analysis, MUST remained independently associated with the length of hospital stay (OR: 2.17; 95% CI: 1.45, 3.26; P < 0.001). Kaplan–Meier survival curves showed an increased number of deaths for patients at medium or high risk of malnutrition (P < 0.001). This association was found to be independent of other confounding factors (HR: 1.45; 95% CI: 1.06, 1.99; P = 0.020). Conclusions MUST score is an independent marker of risk in those undergoing surgery for colorectal cancer and should remain a key part of preoperative assessment.

scholarly journals Efficacy of Nutrition Screening Tools in Predicting the Length of Hospital Stay in Older Hospitalized Patients

Acta Medica ◽  
2021 ◽  
pp. 1-7
Author(s):  
Cafer Balcı
Keyword(s):  
Hospital Stay ◽  
Universal Screening ◽  
Global Assessment ◽  
Screening Tool ◽  
Length Of Hospital Stay ◽  
Subjective Global Assessment ◽  
Risk Screening ◽  
Nutrition Risk ◽  
Prolonged Length ◽  
Malnutrition Universal Screening Tool

Objective: The prevalence of malnutrition remains high in older hospitalized patients. Subjective Global Assessment, the Nutrition Risk Screening-2002, and Malnutrition Universal Screening Tool are widely used screening and assessment tools, but comparison of their efficacy in predicting clinical outcomes like length of hospital stay remain scarce. This study aimed to compare the efficacy of these tools in predicting length of hospital stay in a group of older hospitalized patients. Materials and Methods: A retrospective analysis was performed in a sample of 72 patients consecutively admitted to a geriatric medicine ward. Subjective Global Assessment, Nutrition Risk Screening-2002 and Malnutrition Universal Screening Tool were performed within 24 hours of admission. Patients were classified as having prolonged length of hospital stay if they stay in the hospital for more than ten days. The association of baseline malnutrition defined by each tool and the prolonged length of hospital stay was assessed using unadjusted and adjusted logistic regression models. Results: The mean age of the patients was 73.5 ± 6.9 years, and 61.1% were women. The prevalence of malnutrition was 45.8% with Subjective Global Assessment, 51.4% with Nutrition Risk Screening-2002, and 33.3% with Malnutrition Universal Screening Tool. Among the entire cohort, twenty-nine patients (40.2%) had longer length of the hospital stay. After adjusted for covariates, multivariate logistic regression analysis revealed that the Subjective Global Assessment had the best predictive power (OR: 3.9; p: 0.02), followed by Nutrition Risk Screening-2002 (OR: 3.8; p: 0.03), and Malnutrition Universal Screening Tool (OR: 2.9; p: 0.02). Conclusion: Malnutrition assessed by the Subjective Global Assessment, Nutrition Risk Screening-2002 and Malnutrition Universal Screening Tool on admission predict prolonged length of hospital stay in hospitalized older patients.

scholarly journals Assessment of body composition and association with clinical outcomes in patients with lung and colorectal cancer

BJR|Open ◽  
2021 ◽  
Author(s):  
Naomi S Sakai ◽  
Anisha Bhagwanani ◽  
Timothy JP Bray ◽  
Margaret A Hall-Craggs ◽  
Stuart Andrew Taylor
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
Body Composition ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Fatty Infiltration ◽  
Length Of Hospital Stay ◽  
Fat Free Mass ◽  
Whole Body ◽  
Whole Body Mri

Objectives: To assess body composition in patients with non-small cell lung cancer (NSCLC) and colorectal cancer using whole body MRI and relate this to clinical outcomes. Methods: 53 patients with NSCLC (28 males, 25 females; mean age 66.9) and 74 patients with colorectal cancer (42 males, 32 females; mean age 62.9) underwent staging whole-body MRI scans which were post-processed to derive fat mass (FM), fat free mass (FFM) and skeletal muscle (SM) indices and SM fat fraction (FF). These were compared between the two cancer cohorts using two-sided t-tests and the chi-squared test. Measurements of body composition were correlated with outcomes including length of hospital stay, metastatic status and mortality. Results: Patients with NSCLC had significantly lower FFM (p = 0.0071) and SM (p = 0.0084) indices. Mean SM FF was greater in patients with NSCLC (p = 0.0124) and was associated with longer hospital stay (p = 0.035). There was no significant relationship between FM, FFM and SM indices and length of hospital stay, metastatic status or mortality. Conclusions: Patients with NSCLC had lower FFM and SM indices than patients with colorectal cancer and greater SMFF, indicating lower SM mass with fatty infiltration. These findings reflect differences in the phenotype of the two groups and suggest patients with lung cancer are more likely to require additional nutritional support. Advances in knowledge: Body composition differs between NSCLC and colorectal cancer. Patients with NSCLC have both a reduced SM mass and greater SM FF suggesting that they are more nutritionally deplete than patients with colorectal cancer.

scholarly journals Selenium Status in Patients Receiving Short-Term Parenteral Nutrition: Frequency of Deficiency and Response to a Standard Supplementation Regimen

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Julia Walsh ◽  
Nariman D. Karanjia ◽  
Andrew Taylor ◽  
Callum Livingstone
Keyword(s):  
Parenteral Nutrition ◽  
Universal Screening ◽  
Screening Tool ◽  
Reference Range ◽  
Length Of Hospital Stay ◽  
Short Term ◽  
Baseline Serum ◽  
High Prevalence ◽  
Se Deficiency ◽  
Malnutrition Universal Screening Tool

Background. This study aimed to determine the prevalence and correlates of Se deficiency in patients referred for parenteral nutrition (PN) and to assess the response to a standard supplementation regimen. Methods. Adult patients (53) were recruited prior to commencing a PN regimen delivering 32 µg (0.4 µmol) Se per 24–36 h. Serum Se concentrations were measured before and daily during PN. Results. At baseline 49 (92%) patients had serum Se concentrations below the reference range (0.9–1.65 μmol/L). Se concentrations climbed during PN from 0.49±0.23 (mean ± SD) to 0.57±0.22 μmol/L (P<0.05), but in 48 (91%) patients the concentrations remained low at post-PN. Taking a Se concentration below 0.6 μmol/L as indicative of depletion in the presence of an acute phase response (APR), 37 (70%) patients had Se depletion at baseline and in 27 (51%), levels remained low at post-PN. Baseline serum Se predicted the length of hospital stay (r=-0.36, P<0.05). Increased “malnutrition universal screening tool” score predicted low Se (r=-0.93, P<0.05). Conclusions. Patients referred for PN have a high prevalence of Se deficiency, even when the APR is taken into account. Se supplementation of 32 µg Se per 24–36 h is insufficient for most patients. Baseline serum Se may have prognostic value.

scholarly journals PERFIL NUTRICIONAL DE PACIENTES IDOSOS COM COVID-19: UMA REVISÃO INTEGRATIVA

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Raquel Seibel ◽  
Jamile Ceolin
Keyword(s):  
Nutritional Status ◽  
Universal Screening ◽  
Screening Tool ◽  
Risk Screening ◽  
Nutrition Risk ◽  
Malnutrition Universal Screening Tool ◽  
Coronavirus Infections

Introdução: A pandemia da COVID-19 representa um desafio para os sistemas de saúde mundialmente. Os idosos, que apresentam múltiplas comorbidades crônicas, são mais suscetíveis ao COVID-19 e a piora do estado nutricional, principalmente em pacientes hospitalizados. Objetivo: Avaliar o perfil nutricional e desfechos clínicos de pacientes idosos com COVID-19. Métodos: Foi realizada uma revisão integrativa com ensaios clínicos, através de uma busca na base de dados Medline (via Pubmed). A sequência da busca utilizada foi: [(Coronavirus infections) AND (Nutritional Status)]. Foram encontrados 54 artigos. Após a leitura dos estudos foram excluídos 42 artigos por não avaliarem idosos, 4 por não serem com humanos, 3 por serem revisão, 1 por não especificar idade, 1 por não abordar o estado nutricional e 1 por ser em chinês. Resultados: Foram incluídos 2 artigos, um com delineamento transversal e outro retrospectivo, totalizando 323 pacientes hospitalizados e com diagnóstico de COVID-19. A amostra era predominantemente feminina, e a média de idade foi de 70,05±7,3 anos. O estado nutricional foi avaliado através da Mini Avaliação Nutricional, Nutrition Risk Screening 2002, Malnutrition Universal Screening Tool e Índice de Risco Nutricional. Nos idosos com COVID-19, houve alta prevalência de desnutrição e risco nutricional, associado com maior tempo de internação, elevadas despesas hospitalares, pior gravidade da doença e maior alteração de peso do que o grupo com estado nutricional normal. Conclusão: Os resultados sugerem que idosos com COVID-19, em risco nutricional, podem apresentar desfechos clínicos piores do que indivíduos com estado nutricional adequado, entretanto mais estudos são necessários.

scholarly journals ‘Malnutrition Universal Screening Tool’ predicts mortality and length of hospital stay in acutely ill elderly

2006 ◽  
Vol 95 (2) ◽  
pp. 325-330 ◽  
Author(s):  
Rebecca J. Stratton ◽  
Claire L. King ◽  
Mike A. Stroud ◽  
Alan A. Jackson ◽  
Marinos Elia
Keyword(s):  
Clinical Outcome ◽  
Elderly Patients ◽  
Universal Screening ◽  
Screening Tool ◽  
Length Of Hospital Stay ◽  
Complete Information ◽  
Post Discharge ◽  
Hospital Stays ◽  
Malnutrition Universal Screening Tool ◽  
Component Scores

Malnutrition and its impact on clinical outcome may be underestimated in hospitalised elderly as many screening procedures require measurements of weight and height that cannot often be undertaken in sick elderly patients. The ‘Malnutrition Universal Screening Tool’ (‘MUST’)has been developed to screen all adults, even if weight and/or height cannot be measured, enabling more complete information on malnutrition prevalence and its impact on clinical outcome to be obtained. In the present study, 150 consecutively admitted elderly patients (age 85 (sd 5·5) years) were recruited prospectively, screened with ‘MUST’ and clinical outcome recorded. Although only 56% of patients could be weighed, all (n 150) could be screened with ‘MUST’; 58% were at malnutrition risk and these individuals had greater mortality (in-hospital and post-discharge, P<0·01) and longer hospital stays (P=0·02) than those at low risk. Both ‘MUST’ categorisation and component scores (BMI, weight loss, acute disease) were significantly related to mortality (P<0·03). Those patients with no measured or recalled weight (‘MUST’ subjective criteria used) had a greater risk of malnutrition (P<0·002) than those who could be weighed and, within both groups, clinical outcome was worse in those at risk of malnutrition. The present study suggests that ‘MUST’ predicts clinical outcome in hospitalised elderly, in whom malnutrition is common (58%). In those who cannot be weighed, a higher prevalence of malnutrition and associated poorer clinical outcome supports the importance of routine screening with a tool, like ‘MUST’, that can be used to screen all patients.

Nutritional status and nutritional rehabilitation of elderly living in long-term care

2009 ◽  
Vol 150 (44) ◽  
pp. 2028-2036 ◽  
Author(s):  
Zsuzsanna Lelovics
Keyword(s):  
Nutritional Status ◽  
Universal Screening ◽  
Long Term Care ◽  
Screening Tool ◽  
Nutritional Rehabilitation ◽  
Term Care ◽  
Malnutrition Universal Screening Tool ◽  
Elderly Living

A dolgozat témája a tartós bentlakásos intézményekben élők táplálásához és táplálkozásához kapcsolódó legfontosabb tényezők feltérképezése, a szociális otthonokban élő időskorúak tápláltsági állapotának felmérése, és az eredmények alapján a táplálkozási rehabilitációra javaslattétel. Célkitűzések: A tartós bentlakásos intézményekben élő hatvanévesek és idősebbek (időskorúak) tápláltsági állapotának meghatározása. A tartós bentlakásos intézményekben élő időskorúak testtömegindexének (BMI) változása. Az elmúlt fél évtized során a tartós bentlakásos intézményekben élő időskorúak tápláltságiállapot-változásának megállapítása. Az akut és krónikus betegségek összefüggésének megállapítása a tápláltsági állapottal. A tartós bentlakásos intézményekben élő időskorúak klinikai tápszerrel való ellátottságának felmérése. Annak megállapítása, hogy milyen a feltárt vélelmezett befolyásoló tényezők és a MUST szerinti tápláltsági állapot közötti összefüggés. Módszerek: Összesen 4774 hatvanéves és idősebb (28,9–30,9%-át férfiak, 69,1–71,2%-át nők adták, az összes résztvevő átlagéletkora 77,8±8,9 év volt) tartós bentlakásos intézményben élő, önként jelentkező gondozott tápláltsági állapotát szűrtük 2004-ben és 2006-ban a Malnutrition Universal Screening Tool (MUST) kérdőívvel és az általunk összeállított kérdőívvel, 2008-ban a Nutrition Day 2008 nyomtatványait használtuk. Eredmények: Felméréseink eredményei szerint az alultápláltságra veszélyeztetett idős személyek aránya a szociális otthonokban igen nagy (26,8–77,0%). Az ellátottak 29,5%-ánál tápláltságiállapot-felmérés negyedévente vagy annál ritkábban történik. A tápláltsági állapot multifaktoriális, sok tényező határozza meg a tápláltsági állapotot (például mozgáskorlátozottság, láz). Az étvágytalanság és a nyelési nehezítettség 2,5-szer gyakoribb, a mozgáskorlátozottság, a dementia, valamint a hiányos fogazat a nagy rizikójú idősek csoportjában közel kétszer (1,6–1,7-szer) gyakoribb, mint az idős, szociális otthonban élők körében. Az idegrendszeri kórképek szignifikánsan függnek össze a tápláltsági állapottal. Az idegrendszeri betegségek előfordulási gyakorisága az elmúlt években szignifikánsan nőtt. Következtetések: A táplálkozási rehabilitáció nem ér véget a tápláltsági állapot szűrésével, ellenkezőleg, azzal kezdődik. Annak eredményei alapján elengedhetetlen a táplálkozási irányelvek és szükség esetén a személyre szabott étrend meghatározása.

scholarly journals Nutritional risk assessment using Malnutrition Universal Screening Tool (MUST) in COVID-19 patients: An observational study in a tertiary care hospital in Eastern India

2021 ◽  
Author(s):  
SUDESHNA MAITRA NAG ◽  
SUBHROJYOTI BHOWMICK ◽  
SAYANTANI BHOWMICK ◽  
UTTIYA DEB ◽  
DEBARATI KUNDU ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Universal Screening ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Demographic Data ◽  
Tertiary Care ◽  
Nutritional Risk ◽  
Care Hospital ◽  
Malnutrition Universal Screening Tool

Aims: To diagnose malnutrition, the nutritional status of each infected patient should be evaluated before starting general treatment. The role of Malnutrition Universal Screening Tool (MUST) in evaluating nutritional status of COVID-19 patients is still unknown. The aim of this study was to evaluate the use of MUST in assessment of nutritional status of COVID-19 patients. Methods: We retrospectively analyzed the data of hospitalized COVID-19 patients above 18 years of age from July 25th to September 25th, 2020. All COVID-19 patients with a length of hospital stay greater than 24 hours underwent malnutrition screening and nutritional assessment based upon MUST. Demographic data, laboratory parameters and MUST score were retrieved from case files. Results: Out of 106 COVID-19 patients included in the study, 68 (64%) were male and 38 (36%) were female. Number of deaths due to COVID-19 was 17 (16.03%). A total of 22 (20.75%) patients had MUST score of 2 and above. Analysis between MUST score and age group showed statistically significant result (p=0.012). MUST score according to clinical outcome at the end of hospitalization was also statistically significant (p<0.001). Conclusion: Our results highlight a possible role of MUST as screening tool for malnutrition in COVID-19 patients. Keywords: COVID-19, nutritional risk, MUST score, malnutrition, coronavirus

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