Nutritional Risk Screening Tools for Elderly Patients with COVID-19: A Systematic Review

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’ 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.

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Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

Nutrients ◽

10.3390/nu12102956 ◽

2020 ◽

Vol 12 (10) ◽

pp. 2956 ◽

Cited By ~ 1

Author(s):

David Franciole Oliveira Silva ◽

Severina Carla Vieira Cunha Lima ◽

Karine Cavalcanti Mauricio Sena-Evangelista ◽

Dirce Maria Marchioni ◽

Ricardo Ney Cobucci ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Predictive Validity ◽

High Sensitivity ◽

Screening Tools ◽

Nutritional Risk ◽

Nutritional Screening ◽

Risk Screening ◽

Nrs 2002 ◽

Nutritional Risk Screening

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older 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’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the 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 older adults with COVID-19.

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Nutritional risk in critically ill patients: how it is assessed, its prevalence and prognostic value: a systematic review

Nutrition Reviews ◽

10.1093/nutrit/nuaa031 ◽

2020 ◽

Vol 78 (12) ◽

pp. 1052-1068

Author(s):

Aline Cattani ◽

Igor C Eckert ◽

Júlia E Brito ◽

Rafaela F Tartari ◽

Flávia M Silva

Keyword(s):

Systematic Review ◽

Critically Ill ◽

Predictive Validity ◽

Critically Ill Patients ◽

Outcome Prediction ◽

Screening Tools ◽

Nutritional Risk ◽

Nutritional Screening ◽

Protein Balance ◽

Nrs 2002

Abstract Context Nutritional risk (NR) screening is the first step of nutrition care process. Few data are available in literature about its prevalence, nor, to our knowledge, is a universally accepted reference method for the intensive care unit (ICU). Objective The aim for this systematic review was to summarize evidence regarding the prevalence of NR and the predictive validity of different tools applied for NR screening of critically ill patients. Data Sources The PubMed, Embase, and Scopus databases were searched up to December 2019 using the subject headings related to critically ill patients and NR screening. The current systematic review is registered with PROSPERO (identifier: CRD42019129668). Data Extraction Data on NR prevalence, predictive validity of nutritional screening tools, and interaction between caloric-protein balance and NR in outcome prediction were collected. Data Analysis Results were summarized qualitatively in text and tables, considering the outcomes of interest. Results From 15 669 articles initially identified, 36 fulfilled the inclusion criteria, providing data from 8 nutritional screening tools: modified Nutrition Risk in the Critically Ill (mNUTRIC; n = 26 studies) and Nutritional Risk Screening–2002 (NRS-2002; n = 7 studies) were the most frequent; the NR prevalence was 55.9% (range, 16.0% to 99.5%). Nutritional risk was a predictor of 28-day and ICU mortality in 8 studies. Interactions between caloric-protein balance and NR on outcome prediction presented were scarcely tested and presented heterogeneous results (n = 8). Conclusions Prevalence of NR in patients in the ICU varies widely; a satisfactory predictive validity was observed, especially when mNUTRIC or NRS-2002 were applied.

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SUN-PO225: Quantitative Analysis of Nutritional Risk Screening Tools NRS 2002 and PG-SGA in Oncology Outpatients

Clinical Nutrition ◽

10.1016/s0261-5614(19)32857-2 ◽

2019 ◽

Vol 38 ◽

pp. S143

Author(s):

E. Justin ◽

D. Mlakar Mastnak ◽

N. Rotovnik Kozjek

Keyword(s):

Quantitative Analysis ◽

Screening Tools ◽

Nutritional Risk ◽

Risk Screening ◽

Nrs 2002 ◽

Nutritional Risk Screening

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P148 COMPARISON OF NUTRITIONAL RISK SCREENING TOOL (NRS 2002) AND SUBJECTIVE GLOBAL ASSESSMENT (SGA) FOR NUTRITIONAL SCREENING AND ASSESSMENT AT HOSPITAL ADMISSION

Clinical Nutrition Supplements ◽

10.1016/s1744-1161(09)70198-x ◽

2009 ◽

Vol 4 (2) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

E. Ozturk ◽

M. Can ◽

B. Dag ◽

H. Safak ◽

R. Yildiz ◽

...

Keyword(s):

Hospital Admission ◽

Global Assessment ◽

Screening Tool ◽

Nutritional Risk ◽

Subjective Global Assessment ◽

Nutritional Screening ◽

Risk Screening ◽

Nrs 2002 ◽

Nutritional Risk Screening

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Nutritional Risk Screening (NRS 2002) as a tool to predict clinical outcomes in hospitalized patients: a literature review

International Journal of Nutrology ◽

10.54448/ijn22105 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Thiago Rocha de Pinho ◽

Simone Mayane Mendes dos Santos ◽

Renara Leite Rodrigues Rocha

Keyword(s):

Clinical Outcomes ◽

Hospital Readmission ◽

Nutritional Support ◽

Screening Method ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Nutritional Screening ◽

Risk Screening ◽

Nrs 2002 ◽

Nutritional Risk Screening

The presence of malnutrition in hospitalized patients is prevalent and studies show its association with a higher incidence of complications, mortality, length of stay, costs, and increased frequency of hospital readmission. Routine use of simple tracking procedures is recommended. Nutritional screening detects individuals who are malnourished or at risk of developing malnutrition, and who can receive specific nutritional support. Nutritional Risk Screening (NRS 2002) is a nutritional screening method recommended by the European Society for Clinical and Metabolism (ESPEN) and identifies the risk of developing malnutrition in hospitalized patients. The aim of this paper is to review the literature on the NRS screening method (2002) and its relationship with clinical outcomes in hospitalized patients.

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

The Heart Surgery Forum ◽

10.1532/hsf98.2013240 ◽

2013 ◽

Vol 16 (6) ◽

pp. 336

Author(s):

Marko Boban ◽

Viktor Persic ◽

Zeljko Jovanovic ◽

Niksa Drinkovic ◽

Milan Milosevic ◽

...

Keyword(s):

Weight Loss ◽

Heart Surgery ◽

Nutritional Risk ◽

Risk Scores ◽

Risk Screening ◽

Climate Effects ◽

Seasonal Climate ◽

Nrs 2002 ◽

The Impact ◽

Nutritional Risk Screening

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

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