scholarly journals The Geriatric Nutrition Risk Index versus the Mini-Nutritional Assessment Short Form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

2020 ◽  
Author(s):  
Yanli Zhao ◽  
Ning Ge ◽  
Dongmei Xie ◽  
Langli Gao ◽  
Yanyan Wang ◽  
...  

Abstract Backgrounds : Malnutrition has been shown to be associated with poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Methods : Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariable logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receiver Operating Characteristic curves (ROC) analyses and the area under the curve (AUC) . Results : Multivariable analysis revealed that preoperative malnutrition by the MNA-SF was significantly associated with POD. Linear regression analysis showed that preoperative low/high nutritional risk of the GNRI and malnutrition by the MNA-SF were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores for POD was better than GNRI scores (AUC=0.718, 95%CI: 0.64-0.80, P <0.001 vs AUC=0.606, 95%CI: 0.52-0.69, P= 0.019; Delong’s test, P=0.006), but the AUC of GNRI scores and MNA-SF scores have no significant difference when predicting prolonged LOS (AUC=0.611, 95%CI: 0.54-0.69, P= 0.006 vs AUC=0.533, 95%CI: 0.45-0.62, P= 0.421; Delong’s test, P=0.079). Conclusion : The MNA-SF was more effective than the GNRI at predicting the development of POD, but the two nutrition screening methods have similar performance in predicting prolonged LOS among older non-cardiac surgical patients.

2019 ◽  
Author(s):  
Yanli Zhao ◽  
Ning Ge ◽  
Dongmei Xie ◽  
Langli Gao ◽  
Yanyan Wang ◽  
...  

Abstract Backgrounds: Malnutrition has been shown to be associated with a poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Methods : Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariate logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receive Operator Characteristic curves (ROC) analyses and the area under the curve (AUC). Results : Multivariate analysis revealed that high nutritional risk (GNRI < 92) and malnutrition/ risk of malnutrition (MNA-SF < 8 and MNA-SF=8-11) were significantly associated with POD. Linear regression analysis showed that low/high nutritional risk (GNRI=92-98 and GNRI < 92) and malnutrition (MNA-SF < 8) were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores (AUC=0.718, P <0.001, 95%CI: 0.64-0.80) for POD was better than GNRI scores (AUC=0.606, P= 0.019, 95%CI: 0.52-0.69), whereas, GNRI scores (AUC=0.611, P= 0.006, 95%CI: 0.54-0.69) had larger AUC when predicting prolonged LOS as compared to MNA-SF scores (AUC=0.533, P= 0.421, 95%CI: 0.45-0.62). Conclusion : The GNRI was more effective than the MNA-SF at predicting prolonged LOS, but the MNA-SF was a superior predictor of POD in older non-cardiac surgical patients.


Author(s):  
B. Buyukaydin ◽  
A.T. Isik ◽  
P. Soysal ◽  
M. Alay ◽  
R. Kazancioglu

Objective: Chronic kidney disease and malnutrition are serious and frequently encountered co-morbidities among older patients. We evaluated nutritional status of older pre-dialysis patients and the effect of malnutrition on length of stay (LOS) in hospital. Materials and Methods: 65 years and over 33 hospitalized pre-dialysis patients with glomerular filtration rate between 10-30ml/min/1.73m2 were included. There is no control group. For all patients, biochemical analysis was performed. The malnutrition risk was evaluated with Mini Nutritional Assessment Short-Form (MNA-SF) and Geriatric Nutritional Risk Index (GNRI) and LOS in hospital was recorded. Results: Mean GNRI was 98.4±12.9 and the mean MNA-SF was 8±3.15. For all patients, mean LOS was 10.58±9 days. According to MNA-SF, malnourished patients’ LOS was longer and a difference was observed between MNA-SF and GNRI in terms of LOS prediction (p=0.005, p=0.230). Conclusion: For older pre-dialysis patients, MNA-SF is probably a more sensitive index in terms of LOS in hospital prediction.


Parasite ◽  
2020 ◽  
Vol 27 ◽  
pp. 74
Author(s):  
Zhan Wang ◽  
Jin Xu ◽  
Ge Song ◽  
MingQuan Pang ◽  
Bin Guo ◽  
...  

Background: Echinococcosis is a chronic consumptive liver disease. Little research has been carried out on the nutritional status of infected patients, though liver diseases are often associated with malnutrition. Our study investigated four different nutrition screening tools, to assess nutritional risks of hospitalized patients with echinococcosis. Methods: Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the Nutrition Risk Index (NRI) were used to assess 164 patients with alveolar echinococcosis (AE) and 232 with cystic echinococcosis (CE). Results were then compared with European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition diagnosis. Results: According to ESPEN standards for malnutrition diagnosis, 29.2% of CE patients and 31.1% of AE patients were malnourished. The malnutrition risk rates for CE and AE patients were as follows: NRS 2002 – 40.3% and 30.7%; MUST – 51.5% and 50.9%; MNA-SF – 46.8% and 44.1%; and NRI – 51.1% and 67.4%. In patients with CE, MNA-SF and NRS 2002 results correlated well with ESPEN results (k = 0.515, 0.496). Area-under-the-curve (AUC) values of MNA-SF and NRS 2002 were 0.803 and 0.776, respectively. For patients with AE, NRS 2002 and MNA-SF results correlated well with ESPEN (k = 0.555, 0.493). AUC values of NRS 2002 and MNA-SF were 0.776 and 0.792, respectively. Conclusion: This study is the first to analyze hospitalized echinococcosis patients based on these nutritional screening tools. Our results suggest that NRS 2002 and MNA-SF are suitable tools for nutritional screening of inpatients with echinococcosis.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2183
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Marta Lewandowicz ◽  
Ewa Deskur-Śmielecka ◽  
Katarzyna Stachnik ◽  
...  

Up to 28% of elderly residents in Europe are at risk of malnutrition. As uniform diagnostic criteria for malnutrition have not been formulated, in autumn 2018, the Global Leadership Initiative on Malnutrition (GLIM) presented a consensus on its diagnosis. According to the consensus, the diagnosis of malnutrition requires a positive screening test result for the risk of malnutrition, and the presence of at least one etiologic and one phenotypic criterion. This study aimed to assess the diagnostic performance and accuracy of the Mini Nutritional Assessment—Short Form (MNA-SF) against GLIM criteria. The analysis involved 273 community-dwelling volunteers aged ≥ 60 years. All participants were screened for malnutrition with the MNA-SF questionnaire. Next, the GLIM phenotypic and etiologic criteria were assessed in all subjects. Based on the presence of at least one phenotypic and one etiologic criterion, malnutrition was diagnosed in more than one-third of participants (n = 103, 37.7%). According to the MNA-SF, only 7.3% of subjects had malnutrition, and 28.2% were at risk of malnutrition. The agreement between the MNA-SF score and the GLIM criteria were observed in only 22.3% of the population. The sensitivity and specificity of MNA-SF against the GLIM criteria were fair (59.2% and 78.8%, respectively). The area under the curve (AUC) was 0.77, indicating the fair ability of MNA-SF to diagnose malnutrition. Based on the present study results, the best solution may be an optional replacement of the screening tool in the first step of the GLIM algorithm with clinical suspicion of malnutrition.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4160
Author(s):  
Diogo Sousa-Catita ◽  
Maria Alexandra Bernardo ◽  
Carla Adriana Santos ◽  
Maria Leonor Silva ◽  
Paulo Mascarenhas ◽  
...  

Nutrition is an important health issue for seniors. In nursing homes, simple, inexpensive, fast, and validated tools to assess nutritional risk/status are indispensable. A multisurvey cross-sectional study with a convenient sample was created, comparing five nutritional screening/assessment tools and the time required for each, in order to identify the most useful instrument for a nursing home setting. Nutrition risk/status was evaluated using the following tools: Subjective Global Assessment (SGA), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening 2002 (NRS 2002), and calf girth (CG). The time spent completing each tool was recorded. Eighty-three subjects were included. MNA-SF and CG were the screening tools that ranked highest with regards to malnutrition identification. CG failed to identify nutritional risk/malnutrition in seniors with lower limb edema. CG was the fastest tool while SGA was the slowest. This was the first study comparing non-invasive nutritional tools with time expended as a consideration in the implementation. CG is responsive, fast, and reliable in elders without edema. MNA-SF was more efficient at detecting malnutrition cases in the elderly population. Both MNA-SF and CG are considered the most suitable for the nursing home setting.


Author(s):  
L. Chye ◽  
K. Wei ◽  
M.S.Z. Nyunt ◽  
Q. Gao ◽  
S.L. Wee ◽  
...  

Background: Physical frailty is well known to be strongly associated with malnutrition, but the combined impact of physical frailty and cognitive impairment among non-demented older persons (cognitive frailty) on malnutrition prevalence is not well documented. Design: Cross-sectional cohort study. Setting and Participants: Community-dwelling older Singaporeans aged ≥55y (n=5414) without dementia in the Singapore Longitudinal Ageing Study (SLAS-1 and SLAS-2). Measurements: The Mini Nutritional Assessment – short form (MNA-SF) and Nutrition Screening Initiative (NSI) Determine Checklist were used to determine their nutritional status. Participants were categorized as cognitive normal (CN) or cognitive impaired (CI) by Mini Mental State Examination (MMSE<=23), as pre-frail (PF) (score=1-2) or frail (F) (score=3-5) using Fried’s criteria, and as cognitive pre-frail (PF+CI) or cognitive frail (F+CI). Results: The prevalence of cognitive frailty was 1.6%, and cognitive pre-frailty was 5.5% (total, 7.1%). The prevalence of MNA malnutrition was 2.4%, and NSI high nutritional risk was 6.3%. The prevalence of MNA malnutrition was lowest among Robust-CN and highest among Frail-CI (0.5% in Robust-CN, 0.6% in Robust-CI, 2.8% in Pre-frail-CN, 7.3% in Pre-frail-CI, 15.4% in Frail-CN, and 23.1% in Frail-CI). Similarly, the prevalence of NSI high nutritional risk was lowest in Robust-CN (3.7%) and highest in Frail-CI (13.6%). Adjusted for sociodemographic and health status, pre-frailty/frailty-CI versus Robust-CN was associated with the highest odds ratio of association with MNA malnutrition (OR=8.16, p<0.001), although not the highest with NSI high nutritional risk (OR=1.48, p=0.017). Conclusions: An extraordinary high prevalence of malnutrition was observed among older adults with cognitive frailty who should be specially targeted for active intervention.


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