title: The Graz Malnutrition Screening (GMS): a new hospital screening tool for malnutrition.
abstract: Despite the significant impact of malnutrition in hospitalised patients, it is often not identified by clinical staff in daily practice. To improve nutritional support in hospitals, standardised routine nutritional screening is essential. The Graz Malnutrition Screening (GMS) tool was developed for the purpose of malnutrition risk screening in a large hospital setting involving different departments. It was the aim of the present study to validate the GMS against Nutritional Risk Screening (NRS) and Mini Nutritional Assessment-short form (MNA-sf) in a randomised blinded manner. A total of 404 randomly selected patients admitted to the internal, surgical and orthopaedic wards of the University Hospital Graz were screened in a blinded manner by different raters. Concurrent validity was determined by comparing the GMS with the NRS and in older patients (70+ years) with the MNA-sf additionally. According to GMS, 31·9 or 28·5% of the admitted patients were categorised as at 'risk of malnutrition' (depending on the rater). According to the reference standard of NRS, 24·5% of the patients suffered from malnutrition. Pearson's r values of 0·78 compared with the NRS and 0·84 compared with the MNA showed strong positive correlations. Results of accuracy (0·85), sensitivity (0·94), specificity (0·77), positive predictive value (0·76) and negative predictive value (0·95) of GMS were also very high. Cohen's κ for internal consistency of the GMS was 0·82. GMS proves to be a valid and reliable instrument for the detection of malnutrition in adult patients in acute-care hospitals.
authors.affiliation: 1Department of Internal Medicine,Medical University of Graz,Auenbruggerplatz 15,A-8036 Graz,Austria.
authors.forename: Regina E
authors.initials: RE
authors.lastname: Roller
authors.affiliation: 2Center of Dietetics and Applied Nutrition,General Hospital Graz,Auenbruggerplatz 21,8036 Graz,Austria.
authors.forename: Doris
authors.initials: D
authors.lastname: Eglseer
authors.affiliation: 2Center of Dietetics and Applied Nutrition,General Hospital Graz,Auenbruggerplatz 21,8036 Graz,Austria.
authors.forename: Anna
authors.initials: A
authors.lastname: Eisenberger
authors.affiliation: 1Department of Internal Medicine,Medical University of Graz,Auenbruggerplatz 15,A-8036 Graz,Austria.
authors.forename: Gerhard H
authors.initials: GH
authors.lastname: Wirnsberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D058620:Elder Nutritional Physiological Phenomena; D001068:Feeding and Eating Disorders / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015596:Nutrition Assessment; D015995:Prevalence; D012306:Risk; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015431:Weight Loss; D055815:Young Adult
keywords: Adults; ESPEN European Society for Clinical Nutrition and Metabolism; GMS Graz Malnutrition Screening; Hospital nutrition; IT information technology; MNA-sf Mini Nutritional Assessment-short form; Malnutrition; NRS Nutritional Risk Screening; Risk screening; SGA subjective global assessment