Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

2013 ◽  
Vol 16 (6) ◽  
pp. 336
Author(s):  
Marko Boban ◽  
Viktor Persic ◽  
Zeljko Jovanovic ◽  
Niksa Drinkovic ◽  
Milan Milosevic ◽  
...  

<p><b>Background:</b> 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.</p><p><b>Methods:</b> 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.</p><p><b>Results:</b> 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 (<i>P</i> = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (<i>P</i> = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; <i>P</i> = 0.034 versus 0.584; <i>P</i> = 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; <i>P</i> = 0.009), the increase in glucose concentrations (cc = 0.600; <i>P</i> < 0.001), and the decrease in erythrocyte counts (cc = -0.520; <i>P</i> = 0.001) during the colder season.</p><p><b>Conclusion:</b> 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.</p>

2019 ◽  
Vol 3 (2) ◽  
pp. 66-80
Author(s):  
Anil Evrim Gungor ◽  
Perihan Arslan ◽  
Osman Abbasoglu

Purpose: To investigate the nutritional status of patients on admission and during hospital stay, the factors leading to weight loss, and to evaluate patient satisfaction of hospital food. Methods: On admission, Nutritional Risk Screening (NRS-2002), weight, height, Body Mass Index (BMI), mid upper arm circumference (MAC) measurements were carried out; serum total protein and albumin levels were recorded. Upon discharge, measurements of weight, MAC were repeated, along with a food satisfaction questionnaire. Results: Patients with NRS-2002>3, BMI<20, were classified as nutrionally at risk which were 43.6% and 9.4% respectively. Of the patients, 77% lost weight (2.6±1.9 kg). Patients who were determined to be malnourished on admission by BMI and NRS-2002 stayed longer in hospital (p<0.0 and p<0.001, respectively). The relationships between weight loss and lenght of stay, use of medications and period of starvation were significant (p<0.0001, for each). Of the patients, 49.9% did not satisfy with the hospital food. Conclusions: Nutritional status of hospitalized patients should be screened with NRS-2002, assessed and monitored. Keywords: NRS-2002, hospital malnutrition, hospital food services


2019 ◽  
Vol 24 (9) ◽  
pp. 3325-3334
Author(s):  
Adriana Aparecida de Oliveira Barbosa ◽  
Andréa Pereira Vicentini ◽  
Fernanda Ramos Langa

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.


Author(s):  
David Franciole de Oliveira Silva ◽  
Severina Carla Vieira Cunha Lima ◽  
Karine Cavalcanti Mauricio Sena-Evangelista ◽  
Dirce Marchioni ◽  
Ricardo Ney Cobucci ◽  
...  

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in elderly people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants&rsquo; ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), MNA-short form (MNA-sf), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Index (NRI), Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in elderly COVID-19 patients.


2021 ◽  
Vol 8 ◽  
Author(s):  
Hongpeng Liu ◽  
Baoyun Song ◽  
Jingfen Jin ◽  
Yilan Liu ◽  
Xianxiu Wen ◽  
...  

Purpose: Evidence of the impact of nutritional risk on health outcomes and hospital costs among Chinese older inpatients is limited. Relatively few studies have investigated the association between clinical and cost outcomes and nutritional risk in immobile older inpatients, particularly those with neoplasms, injury, digestive, cardiac, and respiratory conditions.Methods: This China-wide prospective observational cohort study comprised 5,386 immobile older inpatients hospitalized at 25 hospitals. All patients were screened for nutritional risk using the Nutrition Risk Screening (NRS 2002). A descriptive analysis of baseline variables was followed by multivariate analysis (Cox proportional hazards models and generalized linear model) to compare the health and economic outcomes, namely, mortality, length of hospital stay (LoS), and hospital costs associated with a positive NRS 2002 result.Results: The prevalence of a positive NRS 2002 result was 65.3% (n = 3,517). The prevalence of “at-risk” patients (NRS 2002 scores of 3+) was highest in patients with cardiac conditions (31.5%) and lowest in patients with diseases of the respiratory system (6.9%). Controlling for sex, age, education, type of insurance, smoking status, the main diagnosed disease, and Charlson comorbidity index (CCI), the multivariate analysis showed that the NRS 2002 score = 3 [hazard ratio (HR): 1.376, 95% CI: 1.031–1.836] were associated with approximately a 1.5-fold higher likelihood of death. NRS 2002 scores = 4 (HR: 1.982, 95% CI: 1.491–2.633) and NRS scores ≥ 5 (HR: 1.982, 95% CI: 1.498–2.622) were associated with a 2-fold higher likelihood of death, compared with NRS 2002 scores &lt;3. An NRS 2002 score of 3 (percentage change: 16.4, 95% CI: 9.6–23.6), score of 4 (32.4, 95% CI: 24–41.4), and scores of ≥ 5 (36.8, 95% CI 28.3–45.8) were associated with a significantly (16.4, 32.4, and 36.8%, respectively) higher likelihood of increased LoS compared with an NRS 2002 scores &lt;3. The NRS 2002 score = 3 group (17.8, 95% CI: 8.6–27.7) was associated with a 17.8%, the NRS 2002 score = 4 group (31.1, 95% CI: 19.8–43.5) a 31.1%, and the NRS 2002 score ≥ 5 group (44.3, 95% CI: 32.3–57.4) a 44.3%, higher likelihood of increased hospital costs compared with a NRS 2002 scores &lt;3 group. Specifically, the most notable mortality-specific comorbidity and LoS-specific comorbidity was injury, while the most notable cost-specific comorbidity was diseases of the digestive system.Conclusions: This study demonstrated the high burden of undernutrition at the time of hospital admission on the health and hospital cost outcomes for older immobile inpatients. These findings underscore the need for nutritional risk screening in all Chinese hospitalized patients, and improved diagnosis, treatment, and nutritional support to improve immobile patient outcomes and to reduce healthcare costs.


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