Predicting clinical outcome of cardiac patients by six malnutrition screening tools

Abstract

Malnutrition is highly prevalent among hospital admissions and associated with, poor response to medical treatment, prolonged hospital stay, increased mortality and cost to the state. The aim of this study is to assess the ability of the nutrition screening tools to predict the clinical outcome of cardiac patients. Five hundred and twenty six patients underwent nutritional screening via Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Short Nutritional Assessment Questionnaire (SNAQ), Mini Nutritional Assessment-Short Form (MNA-SF), Nutritional Risk Screening (NRS) and Subjective Global Assessment (SGA) tools on admission and each subject was followed up until discharge and after one month to identify the clinical course and outcome. The mean hospital stay was 5.3 days and median hospital stay was 4.0 days. The mean hospital stay is increasing with the malnutrition level in MUST, NRS, MNA-SF, MST, NRS and SGA tools. The inpatient mortality is higher in high risk nutritional categories of all six malnutrition screening tools. MNA-SF, MST and SGA tools demonstrate a positive relationship between non-prophylactic antibiotic usage and poor nutritional status. High risk nutritional categories of MNA-SF and MST are associated with prescription of multivitamin/minerals. According to MNA-SF, MST and SGA the follow up mortality was increased with worsening nutritional status. The incidence of readmissions was increased gradually with deteriorating nutritional status categorized by MUST, SNAQ, MST and SGA tools. Malnutrition may be associated with poor clinical outcome of the cardiac patients during and after the hospital stay. Each tool reported a variable prediction in outcomes such as death, infection and prolonged hospital stay due to the poor nutritional status.