Report for evaluation of protein-calorie malnutrition in hospitalised patients

Abstract

To properly evaluate the incidence of protein-calorie malnutrition (PCM) in hospitalised patients, we have compared a log sheet used routinely for all patients admitted to our Hospital Department with the score from Nutritional Risk Screening (NRS) 2002, considered by the European Society of Parenteral and Enteral Nutrition (ESPEN) to be the benchmark screening method for malnutrition in hospitalised patients. The log sheet used in our Hospital Department provides for the evaluation of 4 factors: body mass index (BMI), weight loss in recent months, the presence of hypercatabolism and an estimate of daily calorie intake with respect to requirements. These 4 factors, ranked at three levels of severity, are recorded on a “dual grid” chart that allows for three possible final diagnoses of nutritional risk: low, medium and high. In contrast, NRS 2002 evaluates the sum of 3 factors: impairment of nutritional status, severity of the pathology and possible age over 70, with a total score that can be diagnosed as PCM only if equal to or greater than 3. Of 220 patients admitted to the Endocrinology Department of the SS. Annunziata Hospital (Taranto), all submitted to dual evaluation; equivalence was seen in the PCM diagnoses in 98.2% of the cases (216 out of 220). Specifically, in 90.4% of the cases the rating on our log sheet was medium or low and coincided with a score of 0, 1 or 2, while in 7.8% of the cases the rating on our log sheet was medium or high and coincided with an NRS score of 3 or higher. Only in 1.8% of the cases (4 in 220) was there a lack of agreement between a low risk on our log sheet and an NRS score of 3. In conclusion, the PCM evaluation carried out with the log sheet used in our Hospital Department is comparable to the assessment using NRS 2002, which is considered the benchmark screening method for hospitalised patients.