Nrs-2002 Tool

[Epicuro Kishore]

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Background & aims: Malnutrition is common in hip fracture elderly patients. There is no gold standard for screening nutritional risk. We compared the adequacy of 3 screening tools, their association to nutritional measurements and their ability to predict outcome.

Conclusions: All screening tools were adequate in assessing malnutrition parameters in hip fracture operated elderly patients, however, only the MNA-SF could also predict readmissions and mortality.

Background & aims: NRS-2002 is one of the recommended tools to screen hospitalized patients for malnutrition. NRS-2002 is considered as valid and reliable, but little is known about the inter-rater reliability between different groups of healthcare professionals. The aim of this study was to test the inter-rater reliability of the NRS-2002 tool between department nurses and researchers.

Methods: Inter-rater reliability was measured between the NRS-2002 scores given by department nurses and researchers, using data from a randomized controlled trial (RCT) at a hematological department in a Norwegian hospital.

Results: The mean NRS-2002 score was significantly higher when using researchers' scores compared to the department nurses' scores. The total agreement between the two groups of raters was 59%, kappa = 0.27.

Conclusion: The inter-rater reliability of the NRS-2002 scores given by nurses and researchers was low. More research is needed to study if this is applicable also to other patient groups and in other wards.

Background & aims: Several hip fracture patients are malnourished, but no study has attempted to determine the optimal nutritional screening tool for predicting functional outcomes. We investigated the association between each nutritional status assessed by four nutritional screening tools at admission and functional outcomes during the postoperative acute phase in hip fracture patients.

Methods: The Mini Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Score 2002 (NRS-2002) and the Geriatric Nutritional Risk Index (GNRI) were assessed at admission before surgery. We evaluated the motor domain of the functional independence measure (motor-FIM) score at discharge, efficiency on the motor-FIM (change in the motor-FIM score after postoperative rehabilitation divided by postoperative length of hospital stay), and 10-m walking speed at postoperative 14 days as functional outcomes.

Background: The American Society for Parenteral and Enteral Nutrition recommends nutrition screening in patients admitted to the intensive care unit (ICU) and indicates the use of 2 tools: Nutritional Risk Screening 2002 (NRS 2002) or Nutrition Risk in the Critically Ill (NUTRIC). This study aims to compare nutrition risk detected by NRS 2002 and NUTRIC to identify whether both tools are equivalent for clinical practice in the ICU.

Conclusion: Despite the ability to identify patients with high nutrition risk, NUTRIC and NRS 2002 performed differently and were not concordant, suggesting that are not equivalent for clinical practice in the ICU.

ObjectiveThe Global Leader Initiative on Malnutrition (GLIM) criteria have been recommended for malnutrition diagnosis recently, for which the first step is malnutrition risk screening with any validated tool. This study aims to investigate the incidence of nutritional risk and malnutrition in Crohn's disease inpatients and compare the suitability of Nutritional Risk Screening 2002 (NRS-2002) and Malnutrition Universal Screening Tool (MUST) as the first-step screening tool for GLIM criteria.MethodsWe retrospectively analyzed the clinical data of Crohn's disease inpatients in our hospital from August 2016 to December 2019. NRS-2002 and MUST were used for nutritional screening at the time of admission. GLIM and Patient Generated-Subjective Global Assessment (PG-SGA) were used for malnutrition assessment, respectively. Patients without nutritional risk screened by NRS-2002 but with malnutrition risk screened by MUST were especially screened out. The appendicular skeletal muscle mass index (ASMI), fat-free mass index (FFMI), body fat percent (BFP), and body cell mass (BCM) were measured by the Biospace Inbody S10 composition analyzer.ResultsA total of 146 Crohn's disease patients were enrolled, of which 62.3 and 89.7% had nutritional or malnutrition risk according to NRS-2002 and MUST, respectively. The prevalence of malnutrition assessed by GLIM was 59.6% (87 cases) and 82.2% (120 cases) when NRS-2002 and MUST were used as the first step of GLIM respectively. Meanwhile, 99 patients (67.8%) had malnutrition when assessed by PG-SGA. There were 41 patients who were not at nutritional risk according to NRS-2002 but were at malnutrition risk determined by MUST. At last, 33 patients were GLIM-defined, and 16 patients were PG-SGA-defined malnutrition among the 41 patients.ConclusionThe nutritional risk or malnutrition is common in Crohn's disease inpatients. It is recommended to use a variety of nutritional assessment tools for Crohn's disease inpatients. MUST can be used as a good supplement for the patients with a score of NRS-2002 lower than 3 in order to decrease the miss rate of GLIM-defined malnutrition.

Purpose: To evaluate the use of the Patient-Generated Subjective Global Assessment (PG-SGA) and the Nutrition Risk Screening 2002 (NRS 2002) for the assessment of nutritional status in patients with common malignant tumors.

Conclusions: PG-SGA has greater sensitivity than NRS 2002 in assessing nutritional status for patients with common malignancies and is more appropriate for nutritional assessment of cancer patients.

The incidence of malnutrition among hospitalized patients withcancer is high and varies dependent on the tumor location,tumor stage, therapeutic method, and nutritional assessmenttool used. Several studies have reported that the occurrencerate of malnutrition related to cancer is 30-87% [1-8].Malnutrition extends hospital stay, increases health care cost,reduces the quality of life, increases operative risks andcomplications, and impairs tolerance to chemotherapy andradiotherapy [9]. Some studies have suggested thatapproximately 20-50% of the mortality factors of cancerpatients are related to malnutrition rather than to the canceritself [10]. The quality of life and prognosis of patients withtumors will be improved and the complications reduced if theirnutritional status is improved.

Nutritional therapy for patients with cancer has graduallyreceived clinical attention and become a major component of comprehensive treatment of patients with malignant tumors.However, nutritional therapy only benefits patients who have anutritional risk or malnutrition. Furthermore, excessivenutritional treatment may expose patients to infection;aggravate their economic burden, and waste medical resources.Therefore, current consensus is that nutritional therapy isbeneficial for patients with cancer who have a nutritional riskor malnutrition but is not needed for patients without anutritional risk or malnutrition. Therefore, timely, accurate, anddynamic assessment of nutritional status is important fornutritional cancer treatment.

In addition to completing the questionnaire, in the earlymorning of the second day after admission, fasting venousblood samples were obtained from each enrolled patient tomeasure serum albumin and pre-albumin levels.

For all 482 patients, the incidence of malnutrition risk was50.2% according to NRS 2002, while the rate of malnutritionwas 74.5% according to PG-SGA. In addition, we found thatthe positive rate of PG-SGA was significantly higher than thatof NRS 2002 in these patients (P

In chemotherapy or radiotherapy group, the differences in thelength of hospital stay and the hospitalization costs betweenpatients with and without malnutrition risk and nutrition scoreswere significant (P

Bauer et al. used SGA and PG-SGA to assess nutritional status.When SGA was set as the standard, the sensitivity of PG-SGAwas 98% and the specificity 82%. They concluded that PGSGA was a fast, effective, and reliable tool for the assessmentof nutritional status of patients with malignancies [18].Additional studies have shown that PG-SGA score is closelyrelated to weight loss, the length of hospital stay, quality oflife, and energy intake of the patients [19,20]. In this study,PG-SGA and NRS 2002 scores both had weakly positivecorrelations with the length of hospital stay and hospitalizationcosts of cancer patients who were hospitalized forchemotherapy or radiotherapy, but were not correlated withthose variables in patients hospitalized for surgery. Theseresults may be associated with the fact that comprehensivestandardized surgery has not been performed at our hospital,and we have different standards for hospital discharge andsurgical methods.

PG-SGA is mainly based on diet, recent changes in bodyweight, clinical symptoms, physical examination, and somelaboratory measurements. However, in this study PG-SGAscore had a weak negative correlation with BMI and serumalbumin and prealbumin levels. In contrast, NRS 2002 is basedon BMI and albumin level. NRS 2002 has lower sensitivitythan PG-SGA because the latter is based on objectivelaboratory data. In addition, the cost of using the PG-SGA as anutritional assessment tool was lower, and it is more easilyaccepted by patients during outpatient reexamination.Nevertheless, PG-SGA failed to screen for malnutritionaccording to a BMI

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