¿Cómo detectar a los pacientes mayores no institucionalizados en riesgo de malnutrición durante su hospitalización? Comparación de 8 herramientas de cribado de malnutrición o de riesgo nutricional

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
I. García-Fuente , L. Corral-Gudino , M. Gabella-Martín , V.E. Olivet-de-la-Fuente , J. Pérez-Nieto , P. Miramontes-González
{"title":"¿Cómo detectar a los pacientes mayores no institucionalizados en riesgo de malnutrición durante su hospitalización? Comparación de 8 herramientas de cribado de malnutrición o de riesgo nutricional","authors":"I. García-Fuente ,&nbsp;L. Corral-Gudino ,&nbsp;M. Gabella-Martín ,&nbsp;V.E. Olivet-de-la-Fuente ,&nbsp;J. Pérez-Nieto ,&nbsp;P. Miramontes-González","doi":"10.1016/j.rce.2024.02.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The prevalence of malnutrition is high among the elderly population. Hospital admission is a window of opportunity for its detection.</p></div><div><h3>Objective</h3><p>To assess the concordance of different nutritional scales in hospitalized patients.</p></div><div><h3>Methods</h3><p>Prospective study in non-institutionalized patients over 65<!--> <!-->years of age admitted to an internal medicine department. Five malnutrition screening surveys (MNA, MST, MUST, NRS-2000 and CONUT) and three nutritional risk screening surveys (SCREEN<!--> <!-->3, 8 and 14) were compared. As gold standard we use the Global Leadership Initiative for Malnutrition (GLIM) definition of malnutrition.</p></div><div><h3>Results</h3><p>Eighty-five patients (37% female, median age 83<!--> <!-->years) were included. Forty-eight percent (95%<!--> <!-->CI: 38-59%) of patients were classified as malnourished according to GLIM criteria. The SCREEN<!--> <!-->3 scale was the most sensitive (93%; 95%<!--> <!-->CI: 87-98) and MUST the most specific (91%; 95%<!--> <!-->CI: 85-99). The most effective scale for excluding suspected malnutrition was SCREEN<!--> <!-->3 (LR− 0.17; 95%<!--> <!-->CI: 0.05-0.53) and the best for confirming it was MST (LR+ 7.08; 95%<!--> <!-->CI: 3.06-16.39). Concordance between the different scales was low or very low with kappa indices between 0.082 and 0.465.</p></div><div><h3>Conclusions</h3><p>A comprehensive approach is needed to detect malnutrition in hospitalized patients. More sensitive scales are more useful in initial screening. Nutritional risk tools could be effective at this stage. In a second step, malnutrition should be confirmed according to established criteria such as GLIM.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256524000626/pdfft?md5=98c82139741530d5e1e0ca205af50523&pid=1-s2.0-S0014256524000626-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista clinica espanola","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0014256524000626","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background

The prevalence of malnutrition is high among the elderly population. Hospital admission is a window of opportunity for its detection.

Objective

To assess the concordance of different nutritional scales in hospitalized patients.

Methods

Prospective study in non-institutionalized patients over 65 years of age admitted to an internal medicine department. Five malnutrition screening surveys (MNA, MST, MUST, NRS-2000 and CONUT) and three nutritional risk screening surveys (SCREEN 3, 8 and 14) were compared. As gold standard we use the Global Leadership Initiative for Malnutrition (GLIM) definition of malnutrition.

Results

Eighty-five patients (37% female, median age 83 years) were included. Forty-eight percent (95% CI: 38-59%) of patients were classified as malnourished according to GLIM criteria. The SCREEN 3 scale was the most sensitive (93%; 95% CI: 87-98) and MUST the most specific (91%; 95% CI: 85-99). The most effective scale for excluding suspected malnutrition was SCREEN 3 (LR− 0.17; 95% CI: 0.05-0.53) and the best for confirming it was MST (LR+ 7.08; 95% CI: 3.06-16.39). Concordance between the different scales was low or very low with kappa indices between 0.082 and 0.465.

Conclusions

A comprehensive approach is needed to detect malnutrition in hospitalized patients. More sensitive scales are more useful in initial screening. Nutritional risk tools could be effective at this stage. In a second step, malnutrition should be confirmed according to established criteria such as GLIM.

如何检测住院期间有营养不良风险的非住院老年患者?8 种营养不良或营养风险筛查工具的比较
背景老年人营养不良的发病率很高。方法对内科收治的 65 岁以上非住院患者进行前瞻性研究。比较了五种营养不良筛查调查(MNA、MST、MUST、NRS-2000 和 CONUT)和三种营养风险筛查调查(SCREEN 3、8 和 14)。作为金标准,我们采用了全球营养不良领导倡议(GLIM)对营养不良的定义。根据 GLIM 标准,48%(95% CI:38-59%)的患者被归类为营养不良。SCREEN 3量表的灵敏度最高(93%;95% CI:87-98),MUST的特异度最高(91%;95% CI:85-99)。排除疑似营养不良的最有效量表是 SCREEN 3(LR- 0.17;95% CI:0.05-0.53),而确认营养不良的最佳量表是 MST(LR+ 7.08;95% CI:3.06-16.39)。不同量表之间的一致性较低或很低,卡帕指数介于 0.082 和 0.465 之间。在初步筛查中,灵敏度更高的量表更有用。营养风险工具可在此阶段发挥有效作用。第二步,应根据 GLIM 等既定标准确认营养不良。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Revista clinica espanola
Revista clinica espanola 医学-医学:内科
CiteScore
4.40
自引率
6.90%
发文量
73
审稿时长
28 days
期刊介绍: Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI). The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Nine issues are published each year, including mostly originals, reviews and consensus documents.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信