Malnutrition Universal Screening Tool Research Articles

Prognostic value of serum 25-hydroxyvitamin D levels and malnutrition status on postoperative complications in patients following laryngectomy with neck dissection.

Postoperative complications (PCs) following total laryngectomy remain a significant challenge, with recent investigations directed toward the impact of nutrition status and vitamin D deficiency. To elucidate the association between preoperative vitamin D level status, malnutrition risk score, and surgical and survival outcomes in patients with advanced laryngeal cancer following total laryngectomy. Prospective cohort study. Sixty-four patients with advanced laryngeal carcinoma treated with total laryngectomy were included in the study. Serum levels of 25(OH) D3 were measured employing a commercial chemiluminescent immunoassay kit, while nutrition status was evaluated using the nutrition risk index (NRI) and Malnutrition universal screening tool (MUST). The mean serum 25(OH) D level was 37.1 ± 19.4 nmol/L (range 11.0-100.6 nmol/L), with 47% of patients exhibiting vitamin D deficiency and 31% displaying insufficiency. Medium/high MUST score had 53% of patients, and moderate/severe NRI was verified in 48% of patients. Univariate logistic regression analysis identified MUST score, GPS score, neutrophil-to-lymphocyte ratio, and circulating 25(OH) D levels as predictive for the occurrence of PCs. In multivariate analysis, MUST score and circulating 25(OH) D levels remained significantly associated with PCs. Patients with high nutrition risk had significantly lower two-year OS rates compared to the medium and low nutrition risk groups, respectively (30% vs. 62% and 83%, p = 0.010). Early identification of malnourished or patients with vitamin D deficiency and those who would benefit from specific nutritional support could be beneficial for minimizing the risk of development of surgical complications and help improve our clinical outcomes.

Malnutrition risk screening in adult oncology outpatients: An ASPEN systematic review and clinical recommendations.

Malnutrition screening is not widely practiced in outpatient cancer centers. This review aims to determine the validity of malnutrition screening tools and provide recommendations for clinical use. Studies identified by a systematic review assessed the general validity of screening tools in adult oncology outpatients from five databases through 2022. The American Society for Parenteral and Enteral Nutrition (ASPEN) convened a working group of members from the Academy of Nutrition and Dietetics, Academy of Oncology Nurse and Patient Navigators, American Cancer Society, American Society for Clinical Oncology, American Society for Nutrition, American Society for Radiation Oncology, Association of Cancer Care Centers, and Oncology Nursing Society to answer the following questions: (1) should clinicians screen for malnutrition, (2) which malnutrition screening tools are recommended, and (3) what are the clinical applications for malnutrition risk screening in adult oncology outpatients? Twenty of 738 studies met the criteria and were reviewed. Six screening tools with specific cut-points demonstrated validity and are recommended, including the Mini Nutritional Assessment (≤23.5), Malnutrition Screening Tool (MST; MST ≥ 2 and patient-led MST ≥ 2), Malnutrition Universal Screening Tool (MUST; MUST ≥ 1 and MUST ≥ 2), Nutrition Risk Screening-2002 (NRS-2002; NRS-2002 ≥ 2 and NRS-2002 ≥ 3), NUTRISCORE ≥ 5, and Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF; PG-SGA SF ≥ 7 and PG-SGA SF ≥ 8). Six screening tools are valid for malnutrition risk identification in oncology ambulatory settings and recommended before treatment initiation and regularly thereafter, depending on treatment course. Research is needed to understand to what extent early diagnosis and management of malnutrition improves the clinical care of oncology patients.

Documentation of anthropometrics in people with cancer: a cross-site collaboration audit in four hospital settings in the UK

BackgroundMalnutrition is a significant risk for patients during cancer treatment. Neglecting to monitor or provide timely dietetic support can result in lower tolerance to treatments and reduced quality of life. This audit aimed to assess the completeness and accuracy of the documentation of anthropometric measurements in medical records and dietetic referral practices across four day-treatment units (DTUs) in England.MethodologyData were collected from electronic patient records of 100 patients in each DTU attending for systemic anti-cancer treatment (SACT) over a 2-week period. Data collected included patients’ demographics, anthropometric data, referrals to dietitians, and whether the patients referred had a MUST score ≥ 2, which was calculated by the authors.ResultsFindings revealed that weights and heights were documented for 58–85% and 94–98% of patients attending DTUs, respectively. On average, 55% (range of 7–85%) of patients had their body mass index (BMI) documented on the day of SACT. The Malnutrition Universal Screening Tool (MUST) was rarely completed (≤ 3% in each centre). Dietetic referral practices varied across centres.ConclusionsFindings highlight the need to improve anthropometric documentation practices in cancer centres, in order to allow better monitoring of malnutrition risk and early nutritional support interventions when needed.

To evaluate dietary protein intake as per recommended dietary allowance (RDA 2020) and correlate it with the malnutrition universal screening tool score (must) in urban Indians aged 40-60 years.

To evaluate dietary protein intake as per recommended dietary allowance (RDA 2020) and correlate it with the malnutrition universal screening tool score (must) in urban Indians aged 40-60 years.

Dietetic Needs in a Memory Assessment & Support Service (MASS) – A Retrospective Analysis

Abstract Background Nutrition issues can occur in all stages of cognitive impairment, but individual needs may not always be promptly identified. Aim To evaluate dietetic needs of this cohort. Methods Retrospective service evaluation of first 50 referrals to a MASS Senior Dietitian, including comparison of nutrition-screening tools validated for older persons: Mini Nutritional Assessment-Short Form (MNA-SF)1 and Malnutrition Universal Screening Tool (MUST)2. Results The first 50 dietetics referrals (total 126 consults) representing 16% of MASS clients in this period. Nutrition screening: MNA-SF MUST ≤ 7 18% malnourished/high risk ≥ 2 34% 8-11 72% at risk of malnutrition 1 32% 12-14 10% not nutritionally at risk 0 34% So MNA-SF identified 90% as malnourished or at risk, while this was 66% with MUST. Individually tailored advice included: Resolution of key issue and discharged (17), 2 clients deceased. Remainder (31) ongoing dietetic follow-up. Conclusion For those with memory impairment early and regular nutrition assessment is important, and the MNA-SF tool is appropriate. Expert Dietetic advice is necessary at all stages of memory impairment.

Malnutrition Diagnosis Among Cancer Outpatients Using Malnutrition Universal Screening Tool in Nyeri County Referral Hospital, Kenya

Cancer burden remain unacceptably high with global incidence of 19.3 Million and 10million cancer mortalities according to the 2020 global cancer estimates. There has been notable improvement in cancer care in Kenya but malnutrition in cancer patients remain highly under-recognised and the malnutrition screening tools remain under-utilised especially in Nyeri county. The main objective of this study was to determine the malnutrition risk among the cancer outpatients attending Nyeri County Referral Hospital using Malnutrition Universal Screening Tool using analytical cross-sectional study design. Sixty one percent of the respondents were female while 39% were male. Breast cancer was the most common cancer type in the population (39%), followed by esophageal and throat cancer at 14.5% and gastric cancer at 14%. Prostate cancer was the most prevalent among the male respondents at 11%. Using the MUST, more than half (51.7%) of the respondents were at a high risk of developing malnutrition, followed by low risk (32.6%) with only 15.7% respondents being at a medium risk of malnutrition. Using the BMI, half of the respondents, (50%) had a normal nutrition status and only 19.8% respondents were underweight. There is a significant difference between classifying nutrition status of cancer patients using BMI and Malnutrition Universal Screening Tool (P<0.05). Malnutrition Universal Screening tool is easy to use and has the ability to identify the risk of malnutrition among cancer patients and can be adopted in cancer care to improve cancer prognosis and reduce malnutrition rates among cancer patients.

WP8.3 - "Effectiveness of Malnutrition Screen and Interventions for Surgical Inpatients - A MUST Score Based Audit"

Abstract Malnutrition significantly impacts surgical inpatients, affecting outcomes like infection rates, hospital stays, and wound healing. This audit evaluates the effectiveness of the Malnutrition Universal Screening Tool (MUST) in identifying at-risk surgical inpatients and examines the subsequent interventions and nutrition assessments. Our prospective audit encompassed surgical inpatients admitted for elective procedures or via the emergency department. Data were collected through patient records and medical charts, focusing on MUST score completion, accuracy, and updates. The audit assessed staff training, consistency in scoring, and the quality of nutrition interventions documented by dietitians. Key findings revealed a high completion rate (83.3%) of MUST scores but identified significant inaccuracies due to insufficient consideration of BMI, weight loss, and acute disease effect. Only a minor percentage (15.6%) of patients had their MUST scores updated. Staff training inadequacies and inconsistent scoring practices were noted. Despite these limitations, clinical teams effectively identified at-risk patients using their judgment and promptly initiated interventions. A malnutrition awareness week was organised with the dieticians, and teaching sessions were conducted for the healthcare staff to enhance understanding and application of the MUST tool. This initiative aimed to raise awareness and improve the quality of malnutrition screening and management. The audit highlights the need for improved accuracy in MUST scoring, enhanced staff training, and ongoing professional development. Recommendations include comprehensive staff training, standardized documentation processes, interdisciplinary collaboration, and patient and family education. This audit underscores the importance of accurate malnutrition screening and effective interventions to improve patient care quality for surgical inpatients. It calls for action plans to address the identified gaps, thereby enhancing malnutrition management within healthcare settings.

Prevention and Management of Malnutrition in Patients with Chronic Obstructive Pulmonary Disease: A Scoping Review.

Chronic obstructive pulmonary disease (COPD) is linked to altered nutritional status due to increased catabolism, leading to muscle mass loss. This study aims to identify and map available evidence regarding multidisciplinary interventions focused on prevention, diagnosis and nutrition education, as well as the role of diet, to prevent and manage malnutrition in patients with COPD. A scoping review was conducted using the Cochrane, PubMed/Medline, CINAHL, Embase, Scopus, and Web of Science databases. This study adhered to the Arksey and O'Malley framework and JBI methodology. Of the 1761 records identified, 15 were included. Evidence suggests that the Malnutrition Universal Screening Tool and Mini Nutritional Assessment are the most suitable screening scale. Guidelines have highlighted that personalized nutritional counseling is a very common intervention as it allows for a consideration of all physical, psychological, and social aspects of the patient. The role of healthcare professionals is crucial in the early identification of nutrition-related issues and in educating patients about the prevention and management of malnutrition, both in hospital and community settings. Key aspects include early malnutrition detection, personalized counseling and patient education, and a multidisciplinary approach. These findings provide a foundation for developing of targeted patient educational initiatives to improve the nutritional management of COPD patients.

Evaluating the Outcomes in Patients with Colorectal Cancer Using the Malnutrition Universal Screening Tool: A Systematic Review.

The current systematic review aimed to evaluate the Malnutrition Universal Screening Tool (MUST) for its effectiveness in determining patient outcomes (length of hospital stay, postoperative complications, infection rates, and survival) for colorectal cancer. Utilizing a comprehensive search strategy, this review mined literature up to December 2023 from the PubMed, Scopus, and Embase databases. The focus was on identifying studies that scrutinize the prognostic value of MUST in relation to hospital outcomes in colorectal cancer contexts. Adherence to PRISMA guidelines ensured a systematic approach, encompassing various study designs and outcome measures. Among the seven studies incorporating 1950 patients, a significant correlation emerged between MUST scores and key hospital outcomes. Specifically, patients categorized as high MUST risk faced longer hospital stays, with a mean length of stay for high-risk patients extending up to 26.6 days compared to 14 days for those at lower risk. The prevalence of postoperative complications was substantially higher in the high-risk group, with up to 41.4% of high MUST risk patients experiencing severe complications (Clavien-Dindo 3-5) compared to 8.5% in the low-risk category. Notably, the review found that high MUST scores were strongly predictive of increased postoperative complications and a prolonged hospital stay, underscoring the tool's critical predictive utility for quality of life and use in clinical settings. Therefore, MUST's capability to predict longer hospital stays and a higher incidence of postoperative complications among high-risk patients highlights its essential function in preoperative evaluations and supports the integration of MUST into routine clinical assessments.

Overall mortality for community-dwelling adults over 50years at risk of malnutrition.

It is well reported that malnutrition in acute care is associated with poorer health outcomes including increased mortality. However, the consequences of malnutrition on survival in community settings is uncertain. Malnutrition in people 65years or over is often cited. Nevertheless, this study includes both middle-aged and older adults as current public health policy is highlighting the need to increase disease-free life years and is moving away from just extending life to increase overall longevity. The aim of this study is to describe the association of the risk of malnutrition using the Malnutrition Universal Screening Tool (MUST) with mortality in community-dwelling middle-aged and older adults. We used the UK Biobank to investigate the association between those at risk of malnutrition and mortality in participants aged ≥50years. MUST identified risk of malnutrition and linked data to national death registries confirmed mortality. Years of life lost (YLL) and Cox proportional hazard models with hazard ratios (HR) and confidence intervals (CI) described risk associated with all-cause mortality. There were 502408 participants recruited, 117830 were ≤50years leaving 384578 eligible participants. Based on MUST scores 63495 (16.5%) were at risk of malnutrition with 401 missing some data and excluded. Incidence of mortality for at risk participants was 755 per 100000 person-years, corresponding to 153476 YLL. Of those at risk of malnutrition, 9.5% died versus 7.8% at low risk. Initial survival analysis reported an increased risk of mortality (HR 1.29, 95% CI: 1.25 to 1.33) that decreased after adjusting for confounders (HR 1.14, 95% CI: 1.11 to 1.18) in those at risk of malnutrition versus those at low risk. Risk of malnutrition was associated with increased overall mortality. Modest effect sizes are demonstrated but are supportive of public health policies, which advocate wide-scale community, based nutritional screening for middle-aged and older adults.

Nutritional Assessment in Outpatients with Heart Failure.

Heart failure (HF) is associated with significant alterations in body composition, including malnutrition due to insufficient intake, chronic inflammation and increased energy expenditure. Identifying the prevalence of malnutrition and the risk of sarcopenia in patients with HF is crucial to improve clinical outcomes. This cross-sectional, single-center, observational study involved 121 outpatients diagnosed with HF. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Subjective Global Rating (SGA). Sarcopenia was screened using the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls) questionnaire and diagnosed based on the European Working Group in Older People (EWGSOP2) criteria and functionality with the Short Performance Battery (SPPB) test. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. The study found that 10.7% had cardiac cachexia and 45.4% of deceased patients had been in this condition (p = 0.002). Moderate-to-high risk of malnutrition was identified in 37.1%, 23.9%, and 31.4% of patients according to the MNA, MUST, and SGA tests, respectively. According to the GLIM criteria, 56.2% of patients were malnourished. Additionally, 24.8% of patients had a high probability of sarcopenia, and 57.8% were not autonomous according to SPPB. Patients with less than 30% quadriceps muscle contraction were at a high risk of sarcopenia. There is a high prevalence of malnutrition among outpatients with HF, which is associated with worse prognosis, increased risk of sarcopenia, and greater frailty. These findings underscore the importance of early nutritional and functional assessments in this population to improve clinical outcomes.

Comprehensive analysis of nutritional parameters in patients with idiopathic achalasia: A prospective study in India.

Achalasia cardia, a primary motility disorder of the esophagus, poses significant malnutrition risks. This study aims at comprehensively assessing the nutritional status in untreated achalasia patients, contrasting it with functional gastrointestinal disorders (FGIDs) cases and impact of per-oral endoscopic myotomy (POEM) on nutrition at one-year. We conducted a prospective study, including consecutive achalasia cases, from December 2021 to April 2022 at a tertiary care centre. Biochemical parameters, anthropometry, subjective global assessment (SGA) and malnutrition universal screening tool were used for nutritional assessment. Cases diagnosed with FGIDs served as controls. As many as118 cases (41.2 ± 13.9years, 61% males) with achalasia and 200 controls (43.4 ± 11.9years, 69% males) were included in the study. Sub-types of achalasia included type I (16.9%), II (76.3%) and III (6.8%). Overall, 38.1% and 6.8% cases were moderately and severely malnourished, respectively. As compared to controls, cases with achalasia had lower pre-albumin (19.4 vs. 25.2; p = 0.001), serum calcium (p = 0.012), vitamin D (p = 0.001), serum iron (p = 0.001), triceps fold thickness (p = 0.002) and hand-grip strength (p = 0.001). On univariate analysis, type-I achalasia, body mass index, % weight loss, lower esophageal sphincter pressures and Eckardt scores were predictors of malnourishment (SGA). On multivariate analysis, type of achalasia, mid arm circumference and low body mass index were significant predictors of malnourishment in cases with achalasia. There was significant improvement in the nutritional status after POEM at one-year follow-up. Achalasia patients demonstrate a notably higher risk of malnutrition compared to individuals with FGIDs. Nutritional status significantly improves after POEM. (NCT05161923).

Effects of a Specialized Oral Nutritional Supplement with Dietary Counseling on Nutritional Outcomes in Community-Dwelling Older Adults at Risk of Malnutrition: A Randomized Controlled Trial.

This study investigated the effects of oral nutritional supplements (ONSs) along with dietary counseling (DC) in community-dwelling older adults at risk of malnutrition. In this randomized controlled trial, 196 older adults who were at risk of malnutrition, as identified by the Malnutrition Universal Screening Tool (MUST) were randomly assigned to receive ONSs twice daily with DC (intervention) or DC-only (control) for 60 days. Primary outcome was change in body weight from baseline to day 60. Nutritional status, energy, and macronutrient intakes were measured. A significant larger weight gain was observed in the intervention compared to the control from baseline to day 60 (1.50 ± 0.22 kg, p < 0.0001). The intervention group also showed a significantly greater increase in weight at day 30 (p < 0.0001). Intakes of energy and macronutrients were significantly higher in the intervention group compared to the control group at both days 30 and 60 (all p < 0.0001). The odds of achieving better nutritional status were significantly higher in the intervention group than in the control group (OR:3.9, 95% CI: 1.9, 8.2, p = 0.0001). ONS supplementation combined with DC significantly improved body weight and nutritional outcomes in community-dwelling older adults at risk of malnutrition.

CT Derived Measurement of Body Composition: Observations from a Comparative Analysis of Patients with Colorectal and Lung Cancer

Background CT-derived measures of body composition have been shown to have prognostic value in patients with cancer. However, few studies have compared these observations across tumor types and stages of disease. The aim of the present study was to compare body composition measures between two types of cancers, i.e. colorectal cancer (CRC), which is less inflammatory and patients maintain body composition over a longitudinal study period, whereas lung cancer (LC) is proinflammatory and patients lose more fat and muscle mass using a standard methodology. Methods Clinicopathological characteristics, including those pertaining to nutritional risk/status and systemic inflammation in patients with colorectal cancer (CRC, n = 1047) and lung cancer (LC, n = 662), were compared. The CT image at L3 was used to assess body composition. Comparison of these cohorts was carried out using the chi-square test. Binary logistic regression analysis was performed to assess the impact of clinico-pathological variables on body composition, and scatter plots were used to examine the relationship between body mass index (BMI) and CT-derived measures of body composition. Results According to CT-derived body composition, high subcutaneous (SFI) and visceral fat index (VFI) were common (>70%) in both CRC and LC. Also, low skeletal muscle index (SMI) and density (SMD) were approximately 40–50% and 60–70% in both CRC and LC. Compared with CRC, patients with LC had a higher American Society of Anaesthesia (ASA) (P < 0.001), Malnutrition Universal Screening Tool (MUST) (P < 0.001), modified frailty index (mFI) (P < 0.001), modified Glasgow Prognostic Score (mGPS) (P < 0.001), and neutrophil lymphocyte ratio (NLR) (P < 0.001) scores. On binary logistic regression analysis, MUST, mFI, and NLR were predictors of subcutaneous adiposity (P < 0.05); type of cancer, MUST, and mFI were predictors of visceral obesity (P < 0.001); age, type of cancer, MUST, and mGPS were predictors of low SMI (P < 0.001); and age, type of cancer, mFI, and mGPS were predictors of low SMD (P < 0.05). There was a similar relationship between BMI and other measures of CT-derived body composition across two types of cancers. Conclusion Obesity and low skeletal muscle mass were common in both CRC and LC cohorts despite large differences in comorbidity, nutritional risk, systemic inflammation, and survival, even when normalized for TNM stage. These observations would support the hypothesis that, although prognostic, CT derived body composition analysis primarily reflects patient constitution rather than the effect of tumor stage in patients with cancer. The systemic inflammatory response, as evidenced by mGPS, can be considered as an important therapeutic target and loss of muscle mass in patients with advanced cancer is related to the systemic inflammatory response.

High prevalence of malnutrition in an internal medicine department: results from the AMIDO study

The prevalence of malnutrition in patients is very high in Europe (&gt;70%). An Italian FADOI-SINPE survey revealed that malnutrition is an underestimated problem by internists. The AMIDO study examines malnutrition in Acqui Terme Hospital (Alessandria, Italy) Internal Medicine Department patients. Patients were screened for malnutrition using the Malnutrition Universal Screening Tool (MUST) upon admission. 268 patients (49.63% male) were enrolled, with a median age of 83 years. At admission, the prevalence of malnutrition risk was 48.88%. The proportion of patients who came from home resulted to have a slight decreasing trend among the three subgroups according to MUST (84.67%, 82.76%, and 73.53% in increasing order of MUST score respectively), but was not statistically significant (P=0.10). Dementia [odds ratio (OR): 6.36; 95% confidence interval (CI): 2.52-18.63], heart failure (OR: 2.45; 95% CI: 1.33-4.57), neoplasm (OR: 2.24; 95% CI: 1.08-4.77) and infectious diseases (OR: 2.27; 95% CI: 1.226-4.274) increase malnutrition odds. Increasing attention to malnutrition risk is crucial for patients with dementia, neoplasm, heart failure, and infectious diseases, which raise malnutrition risk probability.

When metabolic comorbidities and risk of malnutrition coexist: The new era of inflammatory bowel disease

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) and risk of malnutrition can coexist in patients with inflammatory bowel disease (IBD). We performed a malnutrition risk assessment as part of the standard follow-up of IBD patients and studied the potential risk factors for being at risk of malnutrition based on the presence or absence of MASLD. MethodsThe Malnutrition Universal Screening Tool (MUST) was used to screen malnutrition risk (MUST ≥1) and controlled attenuation parameter (CAP ≥248 dB/min) to assess MASLD. Adherence to a Mediterranean diet, physical activity, and quality of life were also assessed. ResultsOf 686 evaluated IBD patients, 130 (18.9 %) were identified as being at risk of malnutrition. Patients without MASLD (n = 89 [68.5 %]) were more likely to be at risk than those with MASLD (n = 41 [31.5 %], p = 0.005). However, among patients at risk of malnutrition, those with MASLD were more likely to have active IBD (82.9 %) than patients without MASLD (39.3 %, p < 0.001). Female sex (OR 1.984, p = 0.027) and young age (OR 1.014, p = 0.006) were associated with malnutrition risk only in patients with IBD without MASLD. Being at risk of malnutrition was associated with worse quality of life (p < 0.001), especially in IBD patients with MASLD. ConclusionsMalnutrition risk and quality of life are modified by the presence of MASLD in IBD patients.

Prevalence of Malnutrition and Influence of an Individualized Nutritional Support on the Nutritional Status of Cancer Patients

Background: Muscle mass loss, impaired dietary intake, and poor nutritional status are hallmarks of patients with cancer. Cancer-associated malnutrition can lead to several negative consequences, including poor prognosis, reduced survival, increased therapy toxicity, reduced tolerance and compliance to treatment, and diminished response to drugs. The main aim of this study is to understand the prevalence of malnutrition using Global Leadership Initiative on Malnutrition Criteria (GLIM Criteria) and evaluate the impact of tailor-made nutritional intervention on the nutritional status of patients with cancer. Methods and Material: An interventional prospective study was conducted among 100 adult hospitalized cancer patients. The study was based on the Nutrition Care Process model, where nutritional assessment was done using GLIM criteria and Malnutrition Universal Screening Tool (MUST), and muscle mass was assessed using the Handgrip Dynamometer. Nutritional diagnosis was made based on assessment; nutritional intervention was provided through Individualized Nutritional Counseling &amp; Oral Nutritional Support, and nutritional monitoring was done for patients during their stay in hospital using 24-hour daily dietary recall. Nutritional evaluation was done at the time of discharge using GLIM criteria, MUST, and Handgrip Strength (HGS). Data analysis was done using SPSS v24 statistical software (developed by IBM) to find out the Mean and Standard Deviation. Paired t test, Chi-square test, and Regression Analysis were used to analyze the qualitative variables. Statistical significance was defined as P &lt; 0.05. Results: The current study evaluated 100 participants among whom 26% of participants were malnourished as assessed by MUST and 22% participants had poor muscle strength. A paired t-test was performed and it was found that the calorie intake (1504.1 ± 158.7) and the protein intake (56.08±7.01) were almost double after the nutrition intervention. The difference was found to be highly statistically significant with P &lt; 0.01. Thus, nutrition intervention significantly (P &lt; 0.01) improved calorie and protein intake. The overall mean MUST score at baseline was 0.39 which was reduced significantly (P &lt; 0.000) to 0.17 at the end of the study. The HGS improved significantly (P &lt; 0.000) from 10.02 to 25.51 after the nutrition intervention and it was evidenced by 2.5 times increase in HGS (25.51 ± 2.40) by the end of the study. Conclusion: Individualized nutritional support with continuous monitoring and counseling resulted in improvement in nutritional status as evidenced through their improved MUST score and HGS.

The Accuracy of Height Prediction Equations in Greek Patients: A Cross-Sectional Study.

In clinical settings, standing height measurement is often difficult to perform due to patients' inability to stand upright. Height prediction equations derived from measurements of the length of other body segments have been published; however, they are not readily applicable to all populations since ethnic differences affect the relationship between standing height and body segment length. This cross-sectional study aimed to examine the accuracy of height prediction using the Malnutrition Universal Screening Tool (MUST) height predictive equations among Greek patients and to develop new, nationally representative equations. The study population consisted of 1198 Greek adult outpatients able to stand upright without assistance and without medical conditions that affected their height. Standing height, ulna length, knee height and demi-span measurements were obtained from 599 males and 599 females. Patients were stratified into age groups of <55 and ≥55 years, <60 and ≥60 years and <65 and ≥65 years according to the categories indicated by the MUST for height prediction from alternative measurements. There were positive correlations between standing height and ulna length and knee height and demi-span length (p < 0.001) in both sexes and all age categories. A strong correlation was observed between the measured and predicted standing height using ulna length (rho = 0.870, p < 0.001), knee height (rho = 0.923, p < 0.001) and demi-span length (rho = 0.906, p < 0.001). The average difference between the MUST indicative equations' height predictions from alternative measurements and actual height was -3.04 (-3.32, -2.76), -1.21 (-1.43, -0.988) and 2.16 (1.92, 2.41), respectively. New height prediction equations for Greek patients were identified, with the predicted values closer to the measured standing heights than those predicted with the MUST indicative equations for height prediction from alternative measurements.

Impact of Preoperative Malnutrition on Patients with Pancreatic Neoplasms Post-Duodenopancreatectomy: A Retrospective Cohort Study.

Preoperative malnutrition is a significant factor in patients with pancreatic tumors undergoing pancreaticoduodenectomy. The aim of this study was to assess the association between preoperative malnutrition and delayed discharge within a ten-day timeframe and potential correlations between preoperative malnutrition and postoperative surgical complications. A retrospective cohort study was conducted, recruiting a final sample of 79 patients with benign or malignant cephalic pancreatic tumors from 2015 to 2022. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool, while length of hospital stay and relevant clinical data were extracted from clinical documentation. The preoperative malnutrition risk was high in 21.52% of the sample, moderate in 36.71%, and low in 41.77%. Body mass index (BMI) (p = 0.007) and postoperative surgical complications (p < 0.001) were significantly correlated with delayed discharge. No statistically significant differences were found between levels of malnutrition risk and delayed discharge (p = 0.122), or postoperative surgical complications (p = 0.874). Postoperative complications and BMI emerge as significant risk factors. The limited sample size may have compromised the collection of homogeneous and significant data. Future studies should evaluate the implementation of personalized nutritional screening tools, nutritional assessment plans, and the involvement of specialized health professionals.

Malnutrition risk and associated factors in hospitalized older adult patients with neurological diseases: a retrospective cohort study

ABSTRACT Introduction Malnutrition risk (MR) in older adults with neurological disorders is high, but there is little evidence for validated screening tools in this group, as well as for the clinical and socioeconomic factors associated with a high MR. Objectives To determine the association of MR using the Malnutrition Universal Screening Tool (MUST) with mortality and length of stay (LOS) in older adults with neurological diseases. Secondarily, the association of clinical, and socioeconomic factors with MR and clinical outcomes was sought. Methods A retrospective cohort study was carried out at a third-level neurological disease referral center in Mexico. All patients older than 60 years admitted from January 2017 to December 2018 were considered. MUST, clinical and socioeconomic factors were assessed at hospital admission. Outcomes were followed up to hospital discharge or a maximum of 6 months. Results A total of 765 patients were included, of whom 24.7% (n = 189) were at high risk. A high MR was independently associated with mortality (OR 3.09; 95% CI 1.60-5.98, p = .001) and LOS >14 days (OR 4.38; 95% CI 2.79-6.89, p = <.001). The only factors independently associated with high MR was economic dependence and unemployment. Patients with high MR and economic dependence (OR 4.0; 95% CI 1.34-11.99, p = .013) or unemployment (OR 3.43; 95% CI 1.17-10.06, p = .025) had the highest mortality. Conclusions In hospitalized older adults with neurological diseases, high MR is independently associated with increased mortality and LOS. Economic dependence or unemployment are associated with worse clinical outcomes in patients with high MR.