Development and Validation of a Nutritional Risk Screening Scale for Stroke Patients

IntroductionStroke is a global health problem, and around 62% of stroke patients suffer from malnutrition due to dysphagia, eating speed, or stress response. This study aimed to develop a Nutritional Risk Screening Scale for Stroke Patients (NRSS-SP).Material and methodsIn the current study we construct a theoretical framework by combining stroke characteristics, the risk factors of malnutrition in stroke patients, and clinical experience. Then, using the Delphi method, we formed a pool for entries and combined the opinions and suggestions discussed by experts in a research team. Next, we collected all of the data and information, categorized, merged, and split the pool of entry items' contents. Finally, we formed a pretest scale comprising 11 items after scoring their importance.ResultsThe pretest NRSS-SP comprised 10 items in three fields: physical, psychological, and independence. The score was assigned to each factor according to the evaluation results. (e.g., Disease severity, serum albumin and dysphagia: Score 3, age ≥70 years: Score 1). The cumulative effect of four factors (depression, anxiety, serum level of albumin, and body mass index (BMI)) was 65.512%. The item-level Content Validity Index (CVI) of the NRSS-SP ranged from 0.081 to 1.000, and the scale-level CVI was 0.912. The coefficient of Cronbach’s α ranged from 0.822 to 0.911.ConclusionsAn NRSS-SP (including National Institutes of Health Stroke Scale score, BMI, serum level of albumin, recent weight loss, recent food intake, dysphagia, age, depression, anxiety, and Barthel Index) score ≥6.5 was classified as a malnourishment risk; an NRSS-SP score <6.5 denoted normal nutrition.

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Nutritional Risk Screening 2002: sinnvolles Messinstrument in der Pneumologie?

Pneumologie ◽

10.1055/s-0031-1272329 ◽

2011 ◽

Vol 65 (S 01) ◽

Author(s):

C Priegnitz ◽

I Kietzmann ◽

K Richter ◽

M Treml ◽

WJ Randerath ◽

...

Keyword(s):

Nutritional Risk ◽

Risk Screening ◽

Nutritional Risk Screening 2002 ◽

Nutritional Risk Screening

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Mangelernährung bei geriatrischen Traumapatienten

Osteologie/Osteology ◽

10.1055/s-0037-1620029 ◽

2014 ◽

Vol 23 (01) ◽

pp. 5-10

Author(s):

E.C. Bliemel ◽

R. Aigner ◽

C. Rolfes ◽

S. Ruchholtz ◽

B. Buecking ◽

...

Keyword(s):

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Nutritional Risk ◽

Risk Screening ◽

Prädiktive Validität ◽

Nutritional Risk Screening

ZusammenfassungDie Inzidenz von Mangelernährung geriatrischer Patienten wird im Allgemeinen mit über 50 % angegeben. Mangelernährung bei geriatrischen Traumapatienten rangiert im Kollektiv der proximalen Femurfrakturen zwischen 30 und 50 %. Insgesamt erscheinen sowohl die angegebenen Häufigkeiten als auch die angewandten Messinstrumente inhomogen. Malnutrition führt zu einer Verschlechterung der Wundheilung, einer längeren postoperativen Immobilität, einem verlängerten Krankenhausaufenthalt sowie zu einer Steigerung der Mortalität. Unter Hinzuziehung bestehender Leitlinien erreichen das Mini Nutritional Assessment (MNA) sowie das Nutritional Risk Screening (NRS) eine ausreichende prädiktive Validität in diesem geriatrischen Patientengut, um ein Screening auf Mangelernährung durchzuführen. Bezüglich möglicher therapeutischer Interventionen ist die Studienlage limitiert: Vorhandene Studien zeigen oft eine geringe Patientenzahl und demente Patienten, die besonders häufig mangelernährt sind, wurden häufig ausgeschlossen. Eine Leitlinie explizit für dieses spezielle Patientengut existiert aktuell nicht. Ein suffizientes Screening des Ernährungszustandes sowie Daten zur Durchführbarkeit und Effizienz einer kurzfristigen perioperativen Nahrungsergänzung könnten einen wichtigen Beitrag zur Stabilisierung dieser oft multimorbiden und fragilen Patienten leisten.

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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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