Nutritional Screening In Patients Research Articles

Comparison of different nutritional screening tools in nutritional screening of patients with cirrhosis: A cross-sectional observational study

AimsThe Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT), the Liver Disease Undernutrition Screening Tool (LDUST) and Nutritional Risk Screening 2002 (NRS2002) were used by nurses to screen, compare, and analyze the nutritional status of patients with liver cirrhosis. The application value of different screening tools was summarized in the nutritional screening of patients with liver cirrhosis. MethodsIn this study, LDUST, RFH-NPT, and NRS2002 were used by nurses to screen the nutritional status of hospitalized patients with liver cirrhosis within 24–48 h after admission. The study calculated validity indicators such as sensitivity, specificity, the area under the receiver operating curve (AUC), and reliability indicators such as the Kappa coefficient. The efficacy of these screening tools in the nutritional screening of patients with liver cirrhosis was compared. ResultsAmong the 207 patients, LDUST and NRS2002 identified 72.9 % and 23.7 % as undernourished, respectively. The sensitivity of LDUST and NRS2002 were 92.1 % and 30.0 %, respectively. The Kappa value of LDUST and RFH-NPT was 0.620, and the Kappa value of LDUST compared with NRS2002 was 0.144. ConclusionThis study shows that the Liver Disease Undernutrition Screening Tool, a special screening tool for patients with liver cirrhosis, has a more reliable screening effect and higher sensitivity than NRS2002. The Liver Disease Undernutrition Screening Tool is recommended for nutritional screening in patients with liver cirrhosis.

Clinical usefulness of the patient-generated subjective global assessment short form© for nutritional screening in patients with head and neck cancer: a multicentric study.

Nutritional screening and assessment are considered essential steps in nutritional care for cancer patients, malnutrition remains underreported in clinical practice. The aim of this study was to analyse the clinical usefulness of the Patient-Generated Subjective Global Assessment short form (PG-SGA SF©) for nutritional screening in patients with head and neck cancer (HNC). This is a multicentre, cross-sectional study involving patients with HNC. The final score of the PG-SGA SF© was obtained and the nutritional status was diagnosed using the Patient-Generated Subjective Global Assessment (PG-SGA)®, classifying them as well-nourished or malnourished. Receiver operating characteristic curve, ordinal logistic regression, and C-statistic were used. In total, 353 patients with HNC were enrolled and the prevalence of malnutrition, according to the PG-SGA®, was 64.02% and the median final score of PG-SGA SF© was 11 points. The final score of the PG-SGA SF© had high accuracy (area under the curve = 0.915), and scores ≥9 had the best performance in diagnosing malnutrition. PG-SGA SF© final score ≥9 was associated with malnutrition (odds ratio = 28.32, 95% confidence interval= 15.98-50.17), with excellent discriminatory power (C-statistic = 0.872). In conclusion, the PG-SGA SF© demonstrated excellent performance for nutritional screening in patients with HNC. Given that it is a simple instrument that is faster to administer than the PG-SGA®, we recommend its use in clinical practice among such patients.

P563 Nutritional screening in patients with inflammatory bowel disease: a challenge in the timely diagnosis of malnutrition and sarcopenia

Abstract Background Malnutrition is prevalent in inflammatory bowel disease (IBD) and has been reported in up to 70% in patients with active disease and 38% in patients in remission, being related to sarcopenia, so different tools have been proposed for the nutritional screening of these patients taking into account the importance of early intervention avoiding consequences related to altered body composition such as inadequate response to treatment and poor quality of life, but the evidence in IBD patients is still unclear and there are no studies in Colombian IBD patients. Therefore, the aim of this study is to describe the nutritional status of patients using multiple nutritional screening and assessment tools. Methods Descriptive observational cross-sectional study in patients diagnosed with IBD with clinical activity, by applying nutritional screening tools such as the Malnutrition Universal Screening Tool (MUST) and the Malnutrition Inflammation Risk Tool (MIRT) to determine their nutritional status and degree of sarcopenia. Results Nutritional screening was performed in 20 patients with Inflammatory Bowel Disease, with mild to moderate clinical activity of the disease; patients in clinical remission were excluded. Sixty percent were men and 40% women; with an average age of 44.5 years, 19 years as minimum age and 73 years as maximum age. Taking into account the Malnutrition Universal Screening Tool (MUST), 30% have a high risk of malnutrition, with a higher percentage in men. On the other hand, the MIRT (Malnutrition Inflammation Risk Tool), which evaluates BMI, showed that 25% have a score greater than or equal to 3, which indicates a risk. In addition, and 40% of the population underwent nutritional status assessment in order to rule out sarcopenia. Muscle strength, muscle mass and muscle function were assessed and 25% of this population were diagnosed with sarcopenia and another 25% with possible sarcopenia. Conclusion Patients with IBD are at increased risk of malnutrition, This is the first Colombian study to approach the nutritional assessment of IBD patients with mild to moderate disease activity using nutritional screening tools such as the Malnutrition Universal Screening Tool (MUST) and the Malnutrition Inflammation Risk Tool (MIRT), showing that up to one third of patients are at high risk of malnutrition and 50% have a diagnosis or possible diagnosis of sarcopenia, which is slightly lower than that described in the literature, However, it does raise awareness of the importance of nutritional screening in IBD patients as these alterations have been shown to be associated with increased hospitalisation requirements, number of disease flares and associated complications.

Malnutrition and nutritional screening in patients undergoing surgery in low and middle income countries: A systematic review

AbstractBackgroundThere is a high incidence of preoperative undernutrition in hospitalised patients in low and middle‐income countries (LMICs), leading to increased postoperative complications, length of hospital stay and early mortality. Review aims are to establish the prevalence of undernutrition and assess the use of validated nutritional screening tools in surgical patients across LMICs.MethodsProtocol was PRISMA compliant and Prospero registered (CRD42019126765). Twelve international databases were searched from January 1990 to April 2021. Included studies were on nutritional screening in adults (≥16 years) undergoing surgery in LMICs. Two researchers screened studies and assessed quality. Prevalence of undernutrition was presented as a weighted percentage with confidence intervals (CI).ResultsOf the 4649 records identified, 16 studies (n = 4032) were eligible. Subjective global assessment (SGA) or patient generated (PG)‐SGA were the tools used most widely. SGA and PG‐SGA showed a high prevalence of undernutrition overall (0.61, 95% CI 0.50, 0.73), with a proportion identified with moderate undernutrition (0.44, 95% CI 0.31, 0.57) or severe undernutrition (0.32, 95% CI 0.19, 0.45).ConclusionsData show the prevalence of undernutrition in surgical patients as high as three in five patients within LMICs. Results indicate that the SGA is suitable for assessing this group of patients and that it may be the most appropriate tool to use due to its subjectivity and reliability. PG‐SGA although similar includes more symptom assessment, which is important for nutritionally depleted cancer patients. The limited data on validity and reliability of nutritional screening tools in LMICs indicates further research is required.

Research on Associations of MiR-149 with Nutritional Risk Assessment and Postoperative Complications of Patients with Colorectal Cancer

Background: MiRNAs play an important role in the development of colorectal cancer, however, there’s few evidence of miRNAs in the screening of nutritional risks of patients with colorectal cancer. Objectives: To explore the role of preoperative miR-149 in nutritional screening of patients with CRC, and its associations with clinicopathological characteristics and postoperative complications of patients with CRC. Methods: The associations of serum miR-149 with clinicopathological characteristics and postoperative complications of patients were analyzed. The ROC curves were plotted with miR-149 as the test variable, and the grouping results of patients with nutritional risks [total NRS2002 score ≥3 points] and no nutritional risks (total NRS2002 score <3 points) based on the preoperative NRS2002 score as the state variables. The consistency of miR-149 and NRS2002 in nutritional screening of CRC was analyzed using Kappa test. Results: MiR-149 was low in patients with CRC. There was a statistically significant difference in the miR-149 expression among patients with different tumor diameters and TNM stages in the two groups. The preoperative total NRS2002 score of CRC patients was <3 points (without nutritional risks) in 271 cases, and ≥3 points (with nutritional risks) in 129 cases. The sensitivity and specificity of miR-149 in the diagnosis of nutritional risks were 76.74% and 84.50%. The Kappa value was 0.622 with miR-149 =3.095 as the critical value. Conclusions: MiR-149 can reflect the perioperative nutritional status of patients with CRC, and miR-149 =3.095 can be used as the cut-off point for nutritional risk screening of patients with CRC, which is an important index for assessing the nutritional risk in the perioperative period. The expression of miR-149 has a certain association with postoperative complications.

Utility of the Nutritional Screening in Predicting Adverse Outcome of Patients With Overweight/Obesity and Acute Heart Failure

Undernutrition is a negative predictor of adverse outcomes in patients with heart failure (HF). Despite the survival advantage of elevated body mass index (BMI) in patients with HF, BMI does not necessarily reflect a favorable nutritional status. In the present study, we investigated the clinical impact of nutritional screening in patients with HF and overweight/obesity. We examined the data from 170 patients with overweight or obesity status (defined as BMI ≥ 25 kg/m2) who admitted for acute HF. Their controlling nutritional status (CONUT) score was calculated on admission. The CONUT score is regarded as an index of the nutritional status. The median duration of follow-up was 1096 days (interquartile range, 805-1096 days). Undernutrition was identified in 66.5% of the patients. Kaplan-Meier survival analysis demonstrated that patients with undernutrition had a higher incidence of all-cause death and readmission due to HF than those without undernutrition. Multivariate Cox regression analysis revealed that the CONUT score, but not BMI and the geriatric nutritional risk index, was independently correlated with poor prognosis. Undernutrition is highly prevalent and independently predicts poor outcomes in patients with overweight/obesity and acute HF.

MON-PO366: Nutritional Screening in Patients Admitted to a Oncohematologic Unit

MON-PO366: Nutritional Screening in Patients Admitted to a Oncohematologic Unit

Is Nutritional Screening of Patients with Lung Cancer Optimal? An Expert Opinion Survey of French Physicians and Surgeons

Objectives: To assess how physicians and surgeons carried out malnutrition screening and follow-up for patients with lung cancer.Materials and methods: We carried out an expert opinion survey in France using an anonymous self-administered online questionnaire.Results: In 2017, 206 practitioners responded, of which 60.7% were pulmonologists, 17.4% thoracic surgeons, 11.2% oncologists, and 10.7% radiotherapists. At initial diagnosis, 79.3% of practitioners recorded patients’ percentage of weight loss. During follow-up examinations, 67.5% recorded this data for patients at risk of malnutrition and 70.4 % for malnourished patients. Food intake was evaluated by 21.7% of practitioners at initial diagnosis. Surgeons assessed percentage of weight loss and food intake significantly less often than pulmonologists did, they were less likely to request serum albumin tests and waited for a greater percentage of weight loss before referring patients to a nutrition professional. All practitioners were well aware of the prevalence of malnutrition among lung cancer patients and its consequences. The main factors preventing optimal nutritional assessment reported by practitioners were a lack of time and limited specialized knowledge.Conclusion: Nutritional assessment remained suboptimal, especially for surgical patients. The importance granted to malnutrition needs to be increased for patients with lung cancer, especially in surgical departments.HighlightsPhysicians and thoracic surgeons are well aware of the prevalence and consequences in lung cancer patients.Thoracic surgeons seemed to be less sensitized to malnutrition screening than pulmonologists.Lack of time and limited specialized knowledge were reported as the main factors preventing optimal nutritional assessment.

Application of nutritional screening in patients with tumors of the digestive tract

Application of nutritional screening in patients with tumors of the digestive tract

PTU-097 Nutritional Screening in Patients with Colorectal Cancer Prior to Elective Surgery: Is it Done Accurately and Does It Predict Outcome?

Introduction Patients undergoing surgery for colorectal cancer (CRC) are at high risk of malnutrition, this is detrimental to their post-operative outcome. Nutritional screening is performed pre-operatively using the malnutrition universal screening tool (MUST) but the accuracy of completion and its ability to predict post-operative outcome is currently unknown. Aims To assess the frequency and accuracy in which MUST scoring is completed in the real world setting of a colorectal unit of busy teaching hospital To identify whether the pre-operative MUST score predicts poor outcome after CRC surgery in terms of increased risk of complications and length of hospital stay. Methods 136 consecutive patients undergoing elective surgery for CRC were prospectively independently MUST scored by 2 study investigators. Data was prospectively collected on the MUST score calculated by nursing staff as well as information on patient demographics, operative details and post-operative outcomes. Results 76 (56%) were male. The age range was 46–97, median 73, 75% of the patients were >65. The BMI range was 14.6–43, median 26.1. 32% of the patients had right colon lesions, 21% left colon and 43% rectal. MUST scoring was almost universally completed by nursing staff (98.5%)but the accuracy was poor with significant differences in scores (p = 0.001). The weight loss component of the scoring was the source of error. 73% of the patients had a MUST score of 0, 19% had a score of 1 and 8% ≥ 2. 60% of patients had their surgery by the laparoscopic approach. 61.5% experienced no post-operative complications, 9.5% experienced significant complications (Clavien-Dindo 3 a-5). Hospital length of stay ranged from 0–43 days, median 6 days. MUST score was not able to predict the risk of post-operative outcome as defined by an increased risk of post-operative complications (p = 0.96) or increased length of hospital stay (p = 0.95). ASA status showed a trend towards significance for predicting post-operative complications (p = 0.06). Conclusion MUST screening is almost universally done however the accuracy is poor. There is a risk that patients who are at risk of malnutrition and may benefit from nutritional support are being overlooked. MUST screening alone did not predict an increased length of hospital stay or risk of post-operative complications. The prevalence of malnutrition as detected by MUST score was low. This is likely to be because a significant proportion of the patients were overweight or obese. An alternative screening tool such as the short nutritional assessment questionnaire (SNAQ) might be more suitable in this patient group. Disclosure of Interest None Declared

P-365: Nutritional screening of patients at a memory clinic – association between patients’ and their relatives’ self-reports

P-365: Nutritional screening of patients at a memory clinic – association between patients’ and their relatives’ self-reports

Nutritional screening among patients with cancer in an acute care hospital: a best practice implementation project

This project sought to improve the nutritional screening practice among registered nurses in caring for adult patients with cancer. This project used the pre- and post-implementation audit strategy using Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice (JBI-PACES) module. The audit, feedback and re-audit sequence was the strategy used to improve clinical practice. This project ran over three phases during a 5-month period from July to November 2011. This project utilised three criteria from the JBI-PACES. The criteria are: (i) a validated screening tool is used to identify patients at risk for malnutrition; (ii) patients are screened upon admission using a validated screening tool; and (iii) appropriate action plans are initiated when at-risk patients for malnutrition are identified. According to the pre-implementation audit, only Criterion 1 showed 100% compliance. Criterion 2 and 3 showed 96% and 46% compliance, respectively. The audit team identified four barriers and developed action plans, which included a simplified nutritional screening tool and empowerment of the nurses for dietician referral. The post-implementation audit showed 100% compliance rate achieved for all the three criteria. This project used the pre- and post-audit strategy to translate evidence into practice. It demonstrated not only that implementation of best practice is possible in a busy oncology ward, but also showed a remarkable improvement in the nutritional screening of patients with cancer.

La consultation pré-anesthésique comme outil de dépistage nutritionnel préopératoire

Objective In severely malnourished patients, preoperative nutritional support helps lessen the adverse impact of malnourishment on postoperative progress. An essential prerequisite is to identify this malnourishment. We wanted to find out whether pre-anaesthetic consultation (which is not compulsory in Belgium) was a tool that could be used to achieve these objectives of preoperative nutritional screening in patients undergoing abdominal surgery. Method Our working method comprised of three phases. Having conducted a study to determine our situation, we integrated the NRS 2002 into our computerised consultation protocol and created a procedure used to link our consultation with the dietetics consultation on the same day. We then analysed the effectiveness of our actions. Results We received 87.8% of patients undergoing elective abdominal surgery at the pre-anaesthetic consultation. Thanks to the computerisation of the NRS 2002, our nutritional screening rose from 60.8% to 86.1%. All patients at risk of malnutrition were referred to the dietetics service on the same day for a nutritional assessment and nutritional support if necessary. This procedure reduced the hospital re-admittance rate as much as possible. The average period of 13 to 15 days between the pre-anaesthetic consultation and the surgery was sufficient to put in place preoperative nutritional support. Conclusion Pre-anaesthetic consultation has therefore become a tool used for preoperative nutritional screening and care.

Increased frequency and accuracy of MUST screening after use of a nutrition screening round

Background: Surveys indicate that malnutrition remains common among hospital patients (Russell & Elia, 2010). It is recommended that all patients be screened on admission and weekly (NICE, 2006). The Malnutrition Universal Screening tool (MUST) is a sensitive and specific screening measure (Kyle et al., 2006). In Homerton Hospital, the nutrition screening round (NSR) ran alongside transition of paper-based screening onto an electronic patient record system (EPR). This study aimed to assess the effectiveness of a dietitian-led NSR as a method of training staff to use MUST. Methods: Malnutrition screening was audited on an elderly care ward and an adult rehabilitation unit. The number of MUST scores undertaken within 24 h of admission and the frequency of weekly screening were assessed. Data gathered included the numbers of patients with accurately measured height, weight, body mass index, weight loss and acute disease effect scores. A weekly NSR was then conducted on these two wards alongside consultant ward rounds, with the dietitian carrying out nutritional care and all staff gaining practical experience of MUST by assisting with screening of each patient. After 20 weeks, screening levels were re-audited and, at 24 weeks nursing staff took back full responsibility for MUST screening. A final audit of screening levels took place 1 month after staff on the two designated wards had taken back responsibility for screening. Results: The initial audit indicated that, of 53 patients, 26 had a paper MUST proforma present. Of 23 patients who were on the wards for >7 days who had a MUST proforma, only one was screened each week as per NICE guidelines. The 20-week mid-intervention audit showed that the number of patients on the wards for ≥1 week with an accurate MUST screen recorded on EPR had increased to 100%. Increased detection of malnutrition led to prompt, effective nutrition support. The final audit at 28 weeks showed sustained screening levels, with all patients on the ward for ≥1 week being accurately screened for malnutrition by ward staff alone. Discussion: The NSR appeared to target factors identified as being behind low levels of screening, including a low awareness of screening policy and poor screening skills (Porter, et al., 2009).Confidence in carrying out MUST was increased by ‘hands-on’ training in the immediate patient environment. Perceived barriers to screening cited in other research include pressures of workload (Hodge, 2008). The NSR demonstrated that screening was not as time consuming as assumed and that it could be fitted alongside other tasks. Previous studies have suggested training might be targeted toward all clinical staff (Wong & Gandy, 2008). The NSR project supports this finding, demonstrating that the involvement of all members of the multiprofessional team is strongly conducive to embedding MUST within clinical care and as part of weekly ward routine. Conclusions: A NSR is an effective way of providing practical training in nutritional screening. A NSR raises the ward level profile of screening, encourages it to become routine practice and is a feasible method of increasing frequency of screening in line with policy to enhance patient care.

Importance of early nutritional screening in patients with gastric cancer

In the present study, we evaluated the relationship between nutritional status, disease stage and quality of life (QoL) in 100 patients recently diagnosed with gastric carcinoma. The patients' nutritional status was investigated with anthropometric, biochemical, inflammatory and functional variables; and we also evaluated the nutritional risk with the Nutritional Risk Screening 2002. Oncological staging was standard. QoL was evaluated using the Functional Assessment of Anorexia/Cachexia Therapy questionnaire. The statistical correlation between nutritional risk score (NRS) and oncological characteristics or QoL was evaluated using both univariable and multivariable analyses. Weight loss and reduction of food intake were the most frequent pathological nutritional indicators, while biochemical, inflammatory and functional variables were in the normal range. According to NRS, thirty-six patients were malnourished or at risk for malnutrition. Patients with NRS≥3 presented a significantly greater percentage of stage IV gastric cancer and pathological values of C-reactive protein, while no correlation was found with the site of tumour. NRS was negatively associated with QoL (P<0·001) and this relation was independent from oncological and inflammatory variables as confirmed by multivariable analysis. In the present study, we found that in patients with gastric cancer malnutrition is frequent at diagnosis and this is likely due to reduction in food intake. Moreover, NRS is directly correlated with tumour stage and inversely correlated with QoL, which makes it a useful tool to identify patients in need of an early nutritional intervention during oncological treatments.

An exploratory case study of cancer nurses’ understanding and use of nutritional screening in patients diagnosed with cancer

Background: Cancer is often associated with malnutrition and therefore nutritional support should be considered a major component of treatment and used in adjunct with anti‐neoplastic therapies (Read et al., 2006). Successful nutritional support depends on thorough nutritional assessment (Mercadante, 1996). The literature suggests that systematic screening through the use of a tool enables practitioners to provide relevant nutritional support but this does not occur in practice due to a lack of formal education and gaps in knowledge (Savage &amp; Scott, 2005). This gap in the evidence appears to relate to the nurses’ own perceptions of the importance of nutritional assessment and its’ application in practice. The aim of this study was to explore nurses’ understanding and use of nutritional assessment in patients diagnosed with cancer.Methods: Case study methodology was used to understand the culture of the ward. Sampling was defined by the methodology as the case was chosen to facilitate exploration of the phenomenon. Non‐random sampling was employed as it allowed for the richest possible source of information (O’Leary, 2004). A letter of invitation and information sheet was sent to all eligible nurses. Data from two nursing staff focus groups (n = 7, n = 11), a survey of patient documentation (n = 27) and field observations were used to elicit influences of nursing practice on nutritional risk screening. A tentative focus group question guide was used to ensure that the process had as few interruptions as possible and a moderator facilitated this. The focus groups were audio tape‐recorded and were transcribed verbatim. The data was analyzed using triangulation, looking for phrases and themes that related to the propositions. A mind map was used to explore connections between the themes and propositions along with my own perceptions ensuring transparency of analysis. The case was reported using a reflexive narrative enabling the causal links between the data and propositions to be explored. Study propositions were: did nurses play a critical role in identifying patients at nutritional risk? What were the nurses’ understanding and use of nutritional assessment? Was the nurse's commitment to nutrition inconsistent with their actions and documentation?Results: Nurses’ felt they played a critical role in nutritional risk assessment; ‘it's everyone's responsibility but mainly the nurses and makes a difference in the success of treatment”, this was not reflected in the survey. Their understanding of nutritional risk assessment was apparent ‘you need to get their weight history and what they can eat’but they blamed lack of time and increasing pressures of medicalised tasks, for example drug administration to justify the assessment being observational and ad hoc. The survey of patients’ documentation supported this, 81% of patients had incomplete documentation of their nutritional risk.Discussion: Pressures of workload and conflicting primary tasks influence nurses’ behaviour around nutritional support. The survey of documentation showed that NICE (2006) guidelines have had little impact in practice. Nurses’ are involved in multiple tasks and due to pressures on time and resources have become reactive and not proactive; nutritional assessment is a proactive activity.Conclusions: Lack of recognition the impact ward and organizational culture had on individual behaviour may have been the pivotal factor that led to the inconsistency in understanding and use of nutritional risk assessment. The relationship between nurses’ attitude to nutritional assessment, knowledge of nutrition and practice was complex. The priority of nutrition needs to increase in both the organisation and ward culture in order for nutritional support to be successfully implemented.References Mercadante, S. (1996) Nutrition in cancer patients. Support. Care Cancer 4, 10–20.National Institute for Clinical Excellence. (2006) Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition. London: Department of Health.O’Leary Z. (2004) The Essential Guide to doing Research. London: Sage.Read, J.A. et al. (2006) An evaluation of the prevalence of malnutrition in cancer patients’ attending the oncology outpatient oncology clinic. Asia‐Pacific J. Clin.Oncol.2, 80–86.Savage, J. &amp; Scott, C. (2005) Patients’ nutritional care in hospital: an ethnographic study of nurses’ role and patients’ experience. London: RCN.

Simplifying nutritional screening in patients on hemodialysis

Simplifying nutritional screening in patients on hemodialysis

Nutritional Screening in Patients on Hemodialysis: Is Subjective Global Assessment an Appropriate Tool?

Malnutrition is common in patients with chronic renal failure and should be screened for systematically. Subjective global assessment (SGA) is frequently used, but it is time-consuming. The aim of this study was to assess the sensitivity of SGA as a screening tool for malnutrition compared with the measurement of body mass index (BMI) and serum albumin combined with a history of unintentional weight loss. This was a cross-sectional study. The study was undertaken in two hospital hemodialysis units. A total of 141 patients on hemodialysis were studied. Nutritional assessment was undertaken with a seven-point SGA, measurement of height, weight and serum albumin, and a record of unintentional weight loss. Patients were considered to be at risk of malnutrition if any of the following three criteria were met: a serum albumin less than 35 g/L, a BMI less than 18.5, and unintentional weight loss of edema free weight greater than 10% in the past 6 months. A diagnosis of malnutrition was made if the SGA score was between 1 and 5. A total of 41 patients had either a serum albumin less than 35 g/L or a BMI less than 18.5 or unintentional weight loss of edema free weight of more than 10% in the past 6 months. Of these 41 patients, 29 had a serum albumin less than 35 g/L, 9 had a BMI less than 18.5, and 15 had unintentional loss of edema free weight greater than 10% in the past 6 months. Thirteen patients were judged by SGA to be mild to moderately malnourished. All 13 were identified by serum albumin, BMI, or weight loss. In this study, measurement of SGA did not diagnose malnutrition in any patients in whom this had not already been potentially identified by measurement of serum albumin, BMI, and a history of weight loss. SGA did not therefore increase the sensitivity of nutritional screening in this cohort.