scholarly journals Is There a Better Tool to Identify Patients at Nutritional Risk in Emergency Units?

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 645-645
Author(s):  
Johnny Galhano dos Santos ◽  
Camila Saueressig ◽  
Valesca Dall'Alba
Keyword(s):  
Elderly Patients ◽  
Screening Tool ◽  
Cross Sectional Study ◽  
Nutritional Risk ◽  
Emergency Unit ◽  
Cross Sectional ◽  
Funding Sources ◽  
Kappa Test ◽  
Direct Measurements ◽  
Emergency Units

Abstract Objectives To compare nutritional risk in patients admitted to the emergency unit, by the instruments Nutritional Risk Screening-2002 (NRS), Nutritional Risk Emergency-2017 (NRE), and Malnutrition Universal Screening Tool (MUST). Methods Cross-sectional study, carried out in the emergency unit of a public hospital in Brazil. The sample consisted of adult patients (≥ 19 years old), of both sexes. Nutritional risk was assessed within 24 hours after hospital admission. Patients with a score ≥ 3 by the NRS, ≥ 1.5 by the NRE and, ≥ 2 by the MUST were classified with risk. The NRE is a tool made up of 6 subjective questions, while the NRS and MUST use objective measures of analysis. The data were expressed in absolute (n) and relative (%) frequencies and the analysis of agreement between the instruments was performed using the Kappa test. Results 432 patients were assessed (age 57.31 ± 15.6 years and 54.4% women). The prevalence of nutritional risk by NRS, NRE, and MUST tools was 36%, 45%, and 46%, respectively. There was moderate agreement between the tools, NRS and NRE (Kappa = 0.599 p < 0.01), MUST and NRE (Kappa = 0.594 p < 0.01), MUST and NRS (Kappa = 0.558 p < 0.01). When stratifying the data for elderly patients (age ≥ 60 years), the prevalence of nutritional risk increased for all screening instruments, in particular, the NRE obtained the highest value (61%). Conclusions MUST and NRE were very similar in identifying patients at nutritional risk, however NRE was found to be superior in elderly patients. In addition, the fact that it does not require direct measurements, makes NRE the most suitable screening tool for emergency units. Funding Sources Research and Events Incentive Fund (FIPE) of Hospital de Clínicas de Porto Alegre.

scholarly journals Associação entre ferramenta de triagem e avaliação nutricional entre pacientes hospitalizados no município de Porto Alegre

2020 ◽  
Vol 2 (35) ◽  
pp. 144-148
Author(s):  
Camila Weschenfelder ◽  
Luciane Vieira Figueira ◽  
Talita Sthephanie Scotta Cabral ◽  
Jacqueline Schaurich dos Santos
Keyword(s):  
Predictive Value ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
Cross Sectional Study ◽  
The Body ◽  
Assessment Tools ◽  
Nutritional Risk ◽  
Porto Alegre ◽  
Cross Sectional ◽  
Hospital Malnutrition

Introduction: Hospital malnutrition is associated with the worsening of the patient’s general condition and its early diagnosis allows the reduction of related complications. The aim of this study was to verify the agreement of the Short Nutritional Assessment Questionnaire (SNAQ) screening tool and the Subjective Global Assessment (SGA). Methods: Cross-sectional study, carried out in a general hospital in the city of Porto Alegre (RS). The SNAQ was applied by previously trained nutritionists and nurses, and the patient was considered at nutritional risk when the score was ≥2. SGA was applied by nutritionists in all patients and considered the gold standard for comparison. The Kappa coefficient was used to assess the degree of agreement between the screening and nutritional assessment tools. Kappa values between 0.21-0.60 were considered as low agreement, 0.61-0.8 as moderate agreement and greater than 0.81, as strong agreement. Results: Between January and March 2017, 186 patients were evaluated, of them 115 (62%) were women. The mean age was 65.7 ± 16.6 years and the body mass index (BMI) mean was 26.5 ± 5.5 kg/ m². According to SGA classification, 73.7% of the sample was considered to be well nourished, 14% moderately malnourished and 12.4% severely malnourished. Low agreement was observed between the nutritional risk diagnosed by nursing vs. nutrition through SNAQ (Kappa=0.58) and good agreement of SNAQ applied by the nutrition team with the nutritional diagnosis of SGA (Kappa=0.73). The SNAQ presented sensitivity of 85.7% (95% CI 73.3 - 92.9) and specificity of 90.5% (95% CI 84.4 - 94.4); positive predictive value of 76.4% (95% CI 65.7 - 84.5) and negative predictive value of 94.7% (95% CI 90 - 97.2). Conclusion: We conclude that the screening tool SNAQ when conducted by nutritionists can be used for early detection of hospital malnutrition.

scholarly journals Omitting the First Step of GLIM Framework Yielded Better Accordance With PG-SGA in Chinese Ambulatory Cancer Patients: a Prospective Cross-sectional Study

2021 ◽  
Author(s):  
Yanfei Wang ◽  
Ziqi Liu ◽  
yunyi Wang ◽  
Xiaoyan Chen ◽  
Zhongfen Liu ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Screening Tool ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Severe Malnutrition ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutrition Screening ◽  
Predictive Values

Abstract Background and Aims: The Global Leadership Initiative on Malnutrition (GLIM) criteria is a new framework for diagnosing malnutrition in combination of phenotypic and etiologic criteria after nutrition screening using validated screening tools. The aim of this study was to evaluate the efficacy of malnutrition screening tool (MST), malnutrition universal screening tool (MUST) and nutritional risk screening 2002 (NRS2002) as the first step of GLIM framework in comparison to Patients-Generated Subjective Global Assessment (PG-SGA) in Chinese ambulatory cancer patients.Methods: A single-center prospective cross-sectional study was conducted. Nutritional screening and assessment were performed within 4h after admission to the hospital using a structured questionnaire including MST, MUST, NRS2002, PG-SGA and GLIM, with supplement information of calf circumference (CC) measurement and body composition measurement using bioelectrical impedance analysis (BIA). Malnutrition diagnosis made by GLIM framework using MST, MUST or NRS2002 as the first step or without screening step were compared to PG-SGA separately. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and κ values were used to evaluate performance of the screening tools.Results: Of the 562 included patients, Of the participants 62.8% (355/562) were male and 37.2% (210/562) were female, with a male to female radio of 1.69:1. The median age of the patients was 59.0 years (range, 21-82y; interquels range 52.0-65.0y). From the 562 patients included in the study, 41.8% of patients were evaluated as malnutrition (PG-SGA≥4) and 11.9% were diagnosed as severe malnutrition (PG-SGA D). For GLIM criteria, omitting the screening step yielded fair accordance with PG-SGA in diagnosing malnutrition (κ=0.623) and severe malnutrition (κ=0.515). Using MUST as the first step of GLIM framework has better performance (κ=0.614; κ=0.515) than using MST (κ=0.504, κ=0.496) or NRS2002 (κ=0.363, κ=0.503) as the screening tool regardless of severity gradings.Conclusions: Using PG-SGA as the standard, GLIM framework omitting first step has better performance compared with using MST, MUST or NRS2002 as the screening tool. Among the screening tools validated to be used in the first step of GLIM framework, MUST may be the better choice for ambulatory cancer patients.

scholarly journals Prevalence of nutritional risk in the non-demented hospitalised elderly: a cross-sectional study from Norway using stratified sampling

2015 ◽  
Vol 4 ◽  
Author(s):  
Helene K. Eide ◽  
Jūratė Šaltytė Benth ◽  
Kjersti Sortland ◽  
Kristin Halvorsen ◽  
Kari Almendingen
Keyword(s):  
At Risk ◽  
Elderly Patients ◽  
Cross Sectional Study ◽  
Stratified Sampling ◽  
University Hospital ◽  
Nutritional Risk ◽  
Average Weight ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Wards

AbstractThere is a lack of accurate prevalence data on undernutrition and the risk of undernutrition among the hospitalised elderly in Europe and Norway. We aimed at estimating the prevalence of nutritional risk by using stratified sampling along with adequate power calculations. A cross-sectional study was carried out in the period 2011 to 2013 at a university hospital in Norway. Second-year nursing students in acute care clinical studies in twenty hospital wards screened non-demented elderly patients for nutritional risk, by employing the Nutritional Risk Screening 2002 (NRS2002) form. In total, 508 patients (48·8 % women and 51·2 % men) with a mean age of 79·6 (sd 6·4) years were screened by the students. Mean BMI was 24·9 (sd 4·9) kg/m2, and the patients had been hospitalised for on average 5·3 (sd 6·3) d. WHO's BMI cut-off values identified 6·5 % as underweight, 48·0 % of normal weight and 45·5 % as overweight. Patients nutritionally at risk had been in hospital longer and had lower average weight and BMI compared with those not at risk (all P < 0·001); no differences in mean age or sex were observed. The prevalence of nutritional risk was estimated to be 45·4 (95 % CI 41·7 %, 49·0) %, ranging between 20·0 and 65·0 % on different hospital wards. The present results show that the prevalence of nutritional risk among elderly patients without dementia is high, suggesting that a large proportion of the hospitalised elderly are in need of nutritional treatment.

scholarly journals VALIDITY OF MALNUTRITION UNIVERSAL SCREENING TOOL (MUST) IN GERIATRIC PATIENTS: APPROPRIATE SCREENING TOOL IN HOSPITAL; MUST OR FULL-MNA?

2019 ◽  
pp. 1-6
Author(s):  
S. Hormozi ◽  
M. Alizadeh-Khoei ◽  
F. Sharifi ◽  
M. Chehrehgosha ◽  
R. Esmaeili ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Universal Screening ◽  
Geriatric Patients ◽  
Screening Tool ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Hospitalized Elderly ◽  
Loss Of Appetite

Background: Since malnutrition of geriatric hospitalized patients has an impact on treatment and care management, the aim was to define the accuracy of Malnutrition Universal Screening Test (MUST) for malnutrition screening in the Iranian hospitalized elderly. Methods: In this cross-sectional study elderly 60 ≥ years (N= 192) were selected from two hospitals, anthropometric measures (BMI, MAC, and CC), laboratory test (Albumin), and nutrition tool (Full-MNA) applied and analyzed at P<0.05 level. Results: Elderly participants had a mean age of 68.86 ± 7.46 years and BMI 24.08± 4.64. Elderly patients (28%) lost their weight (>10%) in the last six months and loss of appetite observed in (33.4%) participants. In MUST tool rating, high-risk elderly patients for malnutrition were 33.3%. The AUC for MUST, according to Full-MNA was obtained 90.41%, with sensitivity 90.0% and specificity 73.25%. The MUST showed the strongest correlation with Full-MNA (r = -0.7) and BMI (r = - 0.51); but, the lowest correlation observed with Alb (r= -0.274). Most AUC was belonging to weight loss (0.96) and BMI (0.94). NConclusion: The MUST tool like full-MNA could diagnose malnutrition in geriatric patients in the hospital setting.

scholarly journals Are Nutritional Care Adequate for Elderly Hospitalized Patients? A Cross-Sectional Study

SAGE Open ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. 215824401668206 ◽  
Author(s):  
Helene Kjøllesdal Eide ◽  
Jūratė Šaltytė Benth ◽  
Kjersti Sortland ◽  
Kristin Halvorsen ◽  
Kari Almendingen
Keyword(s):  
Elderly Patients ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutritional Care ◽  
Elderly Hospitalized Patients

This article assesses nutritional care in identifying and treating nutritional risk in elderly hospitalized patients. A cross-sectional study was conducted at a large Norwegian University hospital in the period 2011 to 2013. Data on nutritional risk and care for elderly patients (≥70 years) without dementia were collected at 20 wards by 173 second-year nursing students in acute-care clinical studies. A stratified sampling technique was utilized to improve the representativeness of the sample. In total, 508 patients (48.8% women) with a mean age of 79.6 years participated. The internationally and nationally recommended nutritional care was not implemented at the hospital, suggesting that nutritional care for elderly hospitalized patients was not adequate. This implies that the majority of the elderly patients nutritionally at risk are neither identified nor treated according to their needs. The article highlights the importance of having systematic nutritional care practices to make it possible for the hospital ward staff to routinely identify nutritional risk and initiate appropriate nutritional treatment measures.

scholarly journals Potentially inappropriate medication use among elderly patients on follow-up at the chronic care clinic of a specialized teaching hospital in Ethiopia. A cross-sectional study

2021 ◽  
Author(s):  
Behailu Terefe Tesfaye ◽  
Mihret Terefe Tessema ◽  
Mengist Awoke Yizengaw ◽  
Dula Dessalegn Bosho
Keyword(s):  
Elderly Patients ◽  
Screening Tool ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medication Use ◽  
Stopp Criteria

Abstract Background Elderly patients are prone to potentially inappropriate medication use (PIMU); its use have been associated with multiple adverse consequences. As a result, it is crucial to determine the magnitude and factors associated with PIMU. The present study was mainly aimed to determine and assess the magnitude and predictors of potentially inappropriate medications use in elderly patients on follow-up at the chronic care clinic of Jimma medical center. Methods A retrospective cross-sectional study was conducted involving 219 patients aged 65 years and above on treatment follow-up. Data was collected using checklist. The 2019 updated American Geriatric Society (AGS) Beers Criteria® and Screening Tool of Older People’s Potentially Inappropriate Prescriptions criteria and Screening Tool to Alert Doctors to Right Treatment (STOPP/START) criteria (version 2) were employed to assess PIMU. SPSS IBM (v22) was used for data entry and analysis. Categorical variables were described using frequency and percentage, whereas continuous variables were described using mean with standard deviation (SD) or median with interquartile range (IQR). Logistic regression was conducted to identify predictors of PIMU. Results The average number of medications prescribed per patient was 4.0 (IQR = 2.0). At least one PIMU was identified in 182 (83.1%) and 99 (45.2%) patients, based on Beers and STOPP criteria, respectively. Additionally, potential prescription omission (PPO) was observed in 24 (10.9%) patients. The risk of Beers PIMU was increased with age [AOR = 1.21, p < 0.001], hypertension [AOR = 4.17, p < 0.001], and Polypharmacy [AOR = 14.10, p < 0.001], while a decrease in the risk was noted in patients with a diagnosis of ischemic stroke [AOR = 0.133, p = 0.01] and asthma [AOR = 0.03, p < 0.001]. Using STOPP criteria, hypertension [AOR = 2.10, p = 0.04], diabetes mellitus [AOR = 2.26, p = 0.04], ischemic heart disease [AOR = 2.84, p = 0.04], peripheral neuropathy [AOR = 10.61, p < 0.001], and Polypharmacy [AOR = 6.10, p < 0.001] significantly increased the risk of PIMU. Conclusions Regardless of the screening tool used to assess, the present study revealed PIMU in the large proportion of the participants. Multiple medication use and certain disease condition had increased the probability of PIMU. Thus, it is imperative to use screening tools to review medications prescribed for each hospitalized elderly patients so as to reduce adverse consequences of PIMU.

scholarly journals Evaluation of Nutritional Risk and Prevalence of Obesity in Patients with Covid-19 in A Reference Hospital in Salvador, Bahia, Brazil: A Cross-Sectional Study

2021 ◽  
Vol 14 (01) ◽  
pp. 011-015
Author(s):  
Rodrigo Fernandes Weyll Pimentel ◽  
Gilson Cruz de Moraes ◽  
Shalla Gomes Cavalcanti Barcelos ◽  
Pedro Carlos Muniz de Figueiredo ◽  
Magno Conceição Das Merces
Keyword(s):  
Cross Sectional Study ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Prevalence ◽  
Reference Hospital ◽  
Prevalence Of Obesity ◽  
Nrs 2002 ◽  
Study Type ◽  
Nutritional Risk Screening

Abstract Introduction The Coronavirus has spread to almost every country in the world, causing the coronavirus disease (COVID-19). The coronavirus stands out among the other infections especially by it's high contagious power and important effects on the respiratory system. The COVID-19 has differents ways of presentation and these are influenced by the patient's previous nutricional status, correlated with the patient's lifestyle and comorbities. Objective this survey seeks to analyze the nutritional status and the prevalence of obesity in patients hospitalized with SARS-CoV-2. Methods: this is a descriptive, prospective and cross-sectional study type, which 41 patients affected by COVID-19 were interviewed. Patient's weight and height were used to assess the BMI, and nutritional risk assessment was performed using the Nutritional Risk Screening tool (NRS 2002). For the analysis, Absolute (AF) and Relative Frequency (RF), the mean and the standard deviation were calculated. Results It was observerd that 78% of the participants had a high nutritional risk, while only 22% had a low nutritional risk. Besides that, 34% showed overweight and 41.4% showed obesity. Conclusion the existence of a high prevalence of increased nutritional risk was evidenced, in addition to the high frequency of overweight in patients affected by SARS-CoV-2.

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