Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients.
OBJECTIVE
International nutritional screening tools are recommended for screening hospitalized patients for nutritional risk, but no tool has been specifically evaluated in the Brazilian population. The aim of this study was to identify the most appropriate nutritional screening tool for predicting unfavorable clinical outcomes in patients admitted to a Brazilian public university hospital.


METHODS
The Nutritional Risk Screening 2002 (NRS 2002), Mini-Nutritional Assessment-Short Form (MNA-SF), and Malnutrition Universal Screening Tool (MUST) were administered to 705 patients within 48 h of hospital admission. Tool performance in predicting complications, very long length of hospital stay (LOS), and death was analyzed using receiver operating characteristic curves.


RESULTS
NRS 2002, MUST, and MNA-SF identified nutritional risk in 27.9%, 39.6%, and 73.2% of the patients, respectively. NRS 2002 (complications: 0.6531; very long LOS: 0.6508; death: 0.7948) and MNA-SF (complications: 0.6495; very long LOS: 0.6197; death: 0.7583) had largest areas under the ROC curve compared to MUST (complications: 0.6036; very long LOS: 0.6109; death: 0.6363). For elderly patients, NRS 2002 was not significantly different than MNA-SF (P>0.05) for predicting outcomes.


CONCLUSIONS
Considering current criteria for nutritional risk, NRS 2002 and MNA-SF have similar performance to predict outcomes but NRS 2002 seems to provide a best yield.
Raslan
Mariana
M
Department of Gastroenterology, Medical School, University of São Paulo-LIM 35, São Paulo, Brazil. marianaraslan@hotmail.com
Gonzalez
Maria Cristina
MC
Dias
Maria Carolina Gonçalves
MC
Nascimento
Mariana
M
Castro
Melina
M
Marques
Patrícia
P
Segatto
Sabrina
S
Torrinhas
Raquel Susana
RS
Cecconello
Ivan
I
Waitzberg
Dan Linetzky
DL
D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome