title: Comparing the adequacy of the MNA-SF, NRS-2002 and MUST nutritional tools in assessing malnutrition in hip fracture operated elderly patients.
abstract: Malnutrition is common in hip fracture elderly patients. There is no gold standard for screening nutritional risk. We compared the adequacy of 3 screening tools, their association to nutritional measurements and their ability to predict outcome.
  
  
  
  The Mini Nutrition Assessment Short Form (MNA-SF), the Malnutrition Universal Screening Tool (MUST) and the Nutrition Risk Screening 2002 (NRS-2002) were prospectively determined. Length of stay (LOS), complications, 6 months readmission and up-to 36 months mortality were recorded.
  
  
  
  215 operated patients were included: 154 (71.6%) were women; mean age was 83.5 ± 6.09 years (66-104). According to the MNA-SF, 95 patients were well-nourished, 95 were at risk of malnutrition and 25 were malnourished. Based on the MUST, 171 patients were at a low risk of malnutrition, 31 at a medium risk, 13 at a high risk. According to the NRS-2002, 134 patients were at a low risk of malnutrition, 70 at a medium risk, 11 at a high risk. A significant relationship between the nutritional groups of the 3 scores (p < 0.001) was found. In all screening tools, body mass index, weight loss and food intake prior to admission were found to be related to the patients' nutritional status (p < 0.001). No differences in LOS and complications were found between the patients' nutritional status of each screening tool; only the MNA-SF predicted that well-nourished patients would have less readmissions during a 6 month follow-up (p = 0.024). During a 36 month follow-up, 79 patients died. According to the MNA-SF, mortality was lower in the well-nourished patients vs. the malnourished (p = 0.001) and at risk of malnutrition patients (p = 0.01). A less significant association was found between the NRS-2002 patients' nutritional status and mortality (p = 0.048). The MUST did not reveal this relationship.
  
  
  
  All screening tools were adequate in assessing malnutrition parameters in hip fracture operated elderly patients, however, only the MNA-SF could also predict readmissions and mortality.
authors.affiliation: Nutrition Unit, Rabin Medical Center, Petach Tikva, Israel; Department of Geriatrics, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Koren-Hakim
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Weiss
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Beit Rivka Geriatric Rehabilitation Hospital, Petach Tikvah, Israel.
authors.forename: Avital
authors.initials: A
authors.lastname: Hershkovitz
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Irena
authors.initials: I
authors.lastname: Otzrateni
authors.affiliation: Nutrition Unit, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Anbar
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Revital Feige
authors.initials: RF
authors.lastname: Gross Nevo
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Agata
authors.initials: A
authors.lastname: Schlesinger
authors.affiliation: Nutrition Unit, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Sigal
authors.initials: S
authors.lastname: Frishman
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Orthopedics, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Salai
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: beloy@clalit.org.il.
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000150:complications / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Elderly; Hip fracture; MNA-SF; Nutrition; Screening tools