title: Assessment of risk factors and test performance on malnutrition prevalence at admission using four different screening tools.
abstract: OBJECTIVE
  Malnutrition is very common in patients when admitted to the hospital. The aim of the present study was: a) to determine the prevalence of malnutrition at admission in a tertiary care hospital and identify risk factors for malnutrition, and b) to test the sensitivity and specificity of different screening tests for malnutrition compared to subjective global assessment (SGA).
  
  
  METHODS
  We conducted a prospective study at 24h of admission in order to assess malnutrition in 537 adult subjects (56.4% males, mean age of 61.3±17.7 years) using 4 different screening tools: mininutritional assessment short form (MNA-SF), nutritional risk screening 2002 (NRS2002), malnutrition universal screening tool (MUST), and SGA. Anthropometrics and co-morbidities were registered.
  
  
  RESULTS
  The overall rate of undernutrition was 47.3%. Specific rates were 54.2% in patients > 65y vs. 40.7% < 65y (p = 0.002) and 63.4% in medical vs. 34.0% surgical department (p < 0.001). Identified risk factors of malnutrition at admission were: the presence of heart disease (OR 1.74 CI 95% 1.16-2.60 p = 0.007) for MNASF (AUC 0.62); liver disease (OR 4.45 CI 95% 1.9410.22 p < 0.001), > 65y (OR 2.10 CI 95% 1.19-3.93 p = 0.011), medicine department (OR 3.58 CI 95% 1.93-6.62 p < 0.001) for SGA (AUC 0.96); lung disease (OR 3.34 CI 95% 1.45-7.73 p = 0.005), medicine department (OR 2.55 CI 95%1.09-5.98 p = 0.032) for NRS 2002 (AUC 0.97). Recent unintentional weight loss was a common factor.
  
  
  CONCLUSIONS
  Undernourishment at hospital admission is frequent. Comorbidities may contribute to the presence of undernutrition at admission. Nonetheless, SGA, NRS2002, MNA-SF or MUST can be used in our setting.
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital Son Llàtzer. Palma de Mallorca.. josefinaolivares@gmail.com.
authors.forename: Josefina
authors.initials: J
authors.lastname: Olivares
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital Son Llàtzer. Palma de Mallorca..
authors.forename: Luis
authors.initials: L
authors.lastname: Ayala
authors.affiliation: Unidad de Nutrición Humana. Hospital Universitari de Sant Joan de Reus. Facultad de Medicina y Ciencias de la Salud. Universitat Rovira i Virgili. CIBER Obesidad y Nutrición. Instituto Carlos III..
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital Son Llàtzer. Palma de Mallorca..
authors.forename: Ma José
authors.initials: MJ
authors.lastname: Muñiz
authors.affiliation: Laboratorio de Neurociencias. IUNICS-Universitat de les Illes Balears. Palma de Mallorca..
authors.forename: Antoni
authors.initials: A
authors.lastname: Gamundí
authors.affiliation: Unidad de Epidemiología Clínica. Hospital Universitario de Cruces. Servicio Vasco de Salud. Barakaldo. Bizkaia. Spain..
authors.forename: Lorea
authors.initials: L
authors.lastname: Martínez-Indart
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital Son Llàtzer. Palma de Mallorca..
authors.forename: Lluis
authors.initials: L
authors.lastname: Masmiquel L
mesh_terms: D000328:Adult; D000368:Aged; D003955:Diagnostic Tests, Routine / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors