Simple two-part tool for screening of malnutrition

Abstract

Objective Malnutrition in hospitalized patients is a major problem that is underdiagnosed. Early recognition of malnutrition is important for nutritional support to be effective. Our aims were to determine the malnutrition rate at our center and to devise an effective screening tool for identifying patients at risk for malnutrition. Methods This prospective study included 2211 patients. Each subject was assessed for malnutrition by the Subjective Global Assessment (SGA), and combination criteria (CC), which included anthropometric measurements and laboratory testing. Findings based on these methods were compared with findings in a series of malnutrition screening tests (malnutrition screening tool, self-assessment portion of a mini-nutritional assessment, a question about unintentional weight loss, evaluation of loss of subcutaneous fat, and various combinations of these). Results The SGA and CC methods identified 242 (11.0%) and 345 (15.6%) patients as malnourished, respectively. Of the screening methods that were tested, the combination of unintentional weight loss and loss of subcutaneous fat proved to be the most valuable, with 93% accuracy for predicting malnutrition according to the SGA, and 82.9% accuracy for predicting malnutrition according to CC. The corresponding negative predictive values were 95.5% and 87.3%. Conclusions The results show that this simple two-part nutritional screening tool (unintentional weight loss and loss of subcutaneous fat) is valuable for identifying malnutrition according to the SGA and CC at our institution; however, its validity must be confirmed at other centers.