title: Nutritional risk and status assessment in surgical patients: a challenge amidst plenty.
abstract: OBJECTIVE
  No gold standard exists for nutritional screening/assessment. This cross-sectional study aimed to collect/use a comprehensive set of clinical, anthropometric, functional data, explore interrelations, and derive a feasible/sensitive/specific method to assess nutritional risk and status in hospital practice.
  
  
  METHODS
  100 surgical patients were evaluated, 49M:51F, 55 +/- 18.9 (18-88) years. Nutritional risk assessment: Kondrup's Nutritional Risk Assessment, BAPEN's Malnutrition Screening Tool, Nutrition Screening Initiative, Admission Nutritional Screening Tool. Nutritional status: anthropometry categorised by Body Mass Index and McWhirter & Pennington criteria, recent weight loss > 10%, dynamometry, Subjective Global Assessment.
  
  
  RESULTS
  There was a strong agreement between all nutritional risk (k = 0.69-0.89, p < 0.05) and between all nutritional assessment methods (k = 0.51-0.88, p < or = 0.05) except for dynamometry. Weight loss > 10% was the only method that agreed with all tools (k = 0.86-0.94, p < or = 0.05), and was thereafter used as the standard. Kondrup's Nutritional Risk Assessment and Admission Nutritional Screening Tool were unspecific but highly sensitive (> or = 95%). Subjective Global Assessment was highly sensitive (100%) and specific (69%), and was the only method with a significant Youden value (0.7).
  
  
  CONCLUSIONS
  Kondrup's Nutritional Risk Assessment and Admission Nutritional Screening Tool emerged as sensitive screening methods; the former is simpler to use, Kondrup's Nutritional Risk Assessment has been devised to direct nutritional intervention. Recent unintentional weight loss > 10% is a simple method whereas Subjective Global Assessment identified high-risk/undernourished patients.
authors.affiliation: Centre of Nutrition and Metabolism, Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Mourão
authors.forename: D
authors.initials: D
authors.lastname: Amado
authors.forename: P
authors.initials: P
authors.lastname: Ravasco
authors.forename: P Marqués
authors.initials: PM
authors.lastname: Vidal
authors.forename: M E
authors.initials: ME
authors.lastname: Camilo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D018570:Risk Assessment; D013514:Surgical Procedures, Operative