[Efficacy and effectiveness of different nutritional screening tools in a tertiary hospital].
BACKGROUND
The high prevalence of malnutrition in hospitals and its impact make the use of a nutritional screening tool necessary for its detection, diagnosis and early treatment.


OBJECTIVE
To evaluate the most appropriate tool for nutritional screening, globally and by hospital wards, in a tertiary hospital.


METHODS
cross-sectional study in routine clinical practice. Four nutritional screening tools were evaluated: Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), Malnutrition Universal Screening Tool (MUST), and Nutritional Risk Screening 2002 (NRS-2002). Hospital wards were grouped into: medical wards, General Surgery, Orthopedics, other surgical wards, and Oncology-Hematology. A statistical analysis of sensitivity (S) and specificity (Sp) were performed, and were compared using ROC curve.


RESULTS
There were evaluated 201 patients with median age of 71.6 (RIC 21.4) years and 51.2% were women. The prevalence of nutritional risk (NR) and malnutrition (MN) was: SGS 62.1%, 68.6% MNA, MUST 53.7%, and NRS-2002 35.8%. All the evaluated nutritional screening tools, except MNA, detected a higher prevalence of RN and DN in the medical wards than surgical wards. In the overall analysis the MNA obtained S=93.3%, Sp=71.6% and an area under the ROC curve of 0.825; the MUST obtained S=82.4%, Sp=93.4% and an area under the ROC curve of 0.879; NRS-2002 obtained S=56.0%, Sp=97.4% and an area under the ROC curve of 0.766. These results were similar in the analysis by hospital wards.


CONCLUSIONS
MUST could be the recommended nutritional screening tool to use in a tertiary hospital with elderly population, as the overall good results of sensitivity and specificity, as well as its simplicity.
Unidad de Nutrición Clínica y Dietética. Sección de Endocrinología y Nutrición. Complejo Asistencial Universitario de León. España.. calleja.alicia@gmail.com.
Alicia
A
Calleja Fernández
Unidad de Nutrición Clínica y Dietética. Sección de Endocrinología y Nutrición. Complejo Asistencial Universitario de León. España.. calleja.alicia@gmail.com.
Alfonso
A
Vidal Casariego
Unidad de Nutrición Clínica y Dietética. Sección de Endocrinología y Nutrición. Complejo Asistencial Universitario de León. España.. calleja.alicia@gmail.com.
Isidoro
I
Cano Rodríguez
Unidad de Nutrición Clínica y Dietética. Sección de Endocrinología y Nutrición. Complejo Asistencial Universitario de León. España.. calleja.alicia@gmail.com.
María D
MD
Ballesteros Pomar
D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D015596:Nutrition Assessment; D015203:Reproducibility of Results; D062606:Tertiary Care Centers