Association of Malnutrition Screening Tools with Nutritional Assessment Parameters in Hospitalized Adult Patients
DOI:
https://doi.org/10.3923/pjn.2019.1145.1152Keywords:
Hospitalized patient, Indonesian adults, malnutrition, nutritional assessment, nutritional screeningAbstract
Background and Objective: The prevalence of malnutrition among hospitalized patients is quite high; therefore, the risk formal nutrition needs to be identified early. The objectives of this study were to determine the prevalence of malnutrition and to investigate the relationship between nutritional screening tools and nutritional status parameters. Materials and Methods: This study is an observational study with a cross-sectional design conducted in Waluyo Jati Regional Hospital Probolinggo, Indonesia. The subjects were 211 adult patients who were screened by the nutrition risk screening (NRS) 2002, simple nutrition screening tool (SNST)and malnutrition screening tool (MST) within 24 h of admission. Simple assessment tools, including body mass index (BMI), mid-upper arm circumference (MUAC), total body fat percentage of skeletal muscle, hemoglobin levels and TLC, were used to evaluate nutritional status. Differences in the mean nutritional assessment values between individuals at-risk and not at-risk of malnutrition were analyzed by t-tests. The relationships between the nutritional screening and nutritional assessment values were analyzed using chi-squared tests. Results: The results showed that 54.5% of the patients were at risk of malnutrition based on the NRS 2002 and SNST risk scores, while the MST showed that half of these patients were at risk (29.9%). A total of 47.4, 49.8, 70,6 and 62.6% of the patients were malnourished based on the BMI, MUAC, hemoglobin and TLC measures, respectively. The patients who were at risk of malnutrition had a lower average value of these nutritional parameters than did those not at risk. There were significant associations between all nutrition screening tools and all the nutritional status parameters (p<0,05), except for the TLC. Conclusion: The risk of malnutrition among hospitalized patients was high. The NRS 2002, SNST and MST have a strong correlation with the nutritional screening tools, indicating that lower nutrition screening values correspond to lower nutritional assessment values.
References
Burgos, R., B. Sarto, I. ElÃo, M. Planas and M. Forga et al., 2012. Prevalence of malnutrition and its etiological factors in hospitals. Nutr. Hosp., 27: 469-476.
Correia, M.I.T.D. and A.C.L. Campos, 2003. Prevalence of hospital malnutrition in Latin America:: The multicenter ELAN study. Nutrition, 19: 823-825.
Pirlich, M., T. Schütz, K. Norman, S. Gastell and H.J. Lübke et al., 2006. The German hospital malnutrition study. Clin. Nutr., 25: 563-572.
Susetyowati, S., H. Hadi, M. Hakimi and H.A.H. Asdie, 2014. Development, validation and reliability of the Simple Nutrition Screening Tool (SNST) for adult hospital patient in Indonesia. Pak. J. Nutr., 13: 157-163.
Barker, L.A., B.S. Gout and T.C. Crowe, 2011. Hospital malnutrition: Prevalence, identification and impact on patients and the healthcare system. Int. J. Environ. Res. Public Health, 8: 514-527.
Marshall S., J. Bauer and E. Isenring, 2013. The consequences of malnutrition following discharge from rehabilitation to the community: A systematic review of current evidence in older adults. J. Hum. Nutr. Diet., 27: 133-141.
Kang, M.C., J.H. Kim, S.W. Ryu, J.Y. Moon and J.H. Park et al., 2018. Prevalence of malnutrition in hospitalized patients: A multicenter cross-sectional study. J. Korean Med. Sci., Vol. 33.
Susetyowati, H. Hadi, M. Hakimi and A.H. Aside, 2018. Comparison of nutrition screening and assessment parameters in predicting length of hospital stay. J. Nutr. Med. Diet Care, Vol. 4.
Hamilton, C. and V.J. Boyce, 2013. Addressing malnutrition in hospitalized adults. J. Parenteral Enter. Nutr., 37: 808-815.
Smith, S., T.B. Chamblee, K. Falder-Saeed, K. Haight, M.H. Shuster, M.J. Waldo and H.L. Yoon, 2017. Malnutrition in hospitalized adult patients. Natl. Assoc. Clin. Nurse Spec.
Andini, R., S. Susetyowati and D.C. Sulistyoningrum 2017. Studi komparasi beberapa metode skrining penilaian status gizi pada pasien dewasa rawat inap rumah sakit. J. Gizi Klinik Indonesia, 14: 64-71.
Ancer-Rondriguez, P.R., C. Porrata-Mauri, M. Hernandez-Triana, K. Salinas-Zamora and V. Bernal-Gracia et al., 2014. Nutritional screening and prevalence of hospital malnutrition risk. University hospital of the UANL, Monterrey. Med. Univ., 16: 165-170.
Anthony, P.S., 2008. Nutrition screening tools for hospitalized patients. Nutr. Clin. Pract., 23: 373-382.
Kondrup, J., S.P. Allison, M. Elia, B. Vellas and M. Plauth, 2003. ESPEN guidelines for nutrition screening 2002. Clin. Nutr., 22: 415-421.
Van Bokhorst-de van der Schueren, M.A., P.R. Guaitoli, E.P. Jansma and H.C. de Vet, 2014. Nutrition screening tools: Does one size fit all? A systematic review of screening tools for the hospital setting. Clin. Nutr., 33: 39-58.
Ferguson, M., S. Capra, J. Bauer and M. Banks, 1999. Development of a valid and reliable malnutrition screening tool for adult acute hospital patients. Nutrition, 15: 458-464.
Velasco, C., E. GarcÃa , V. RodrÃguez , L. Frias and R. Garriga et al., 2011. Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: A multicentre study. Eur. J. Clin. Nutr., 65: 269-274.
WHO., 1995. Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee, Technical Report Series No. 854, World Health Organization, Geneva, Switzerland.
Van Tonder, E., L. Mace, L. Steenkamp, R.T. Edwards, K. Gerber and D. Friskin, 2018. Mid-upper arm circumference (MUAC) as a feasible tool in detecting adult malnutrition. S. Afr. J. Clin. Nutr., 32: 93-98.
Bharadwaj, S., S. Ginoya, P. Tandon, T.D. Gohel and J. Guirguis et al., 2016. Malnutrition: Laboratory markers vs nutritional assessment. Gastroenterol. Rep., 4: 272-280.
Khusun, H., R. Yip, W. Schultink, D.H.S. Dillon, 1999. World health organization hemoglobin cut-off points for the detection of anemia are valid for an Indonesian population. J. Nutr., 129: 1669-1674.
Skipper, A., M. Ferguson, K. Thompson, V.H. Castellanos and J. Porcari, 2012. Nutrition screening tools: An analysis of the evidence. J. Parent. Enternal Nutr., 36: 292-298.
Mueller, C., C. Compher and D.M. Ellen, 2011. A.S.P.E.N. clinical guidelines nutrition screening, assessment and intervention in adults. J. Parenteral Enteral Nutr., 35: 16-24.
Wang, F., W. Chen, K.S. Bruening, S. Raj and D.A. Larsen, 2016. Nutrition screening tools and the prediction of clinical outcomes among chinese hospitalized gastrointestinal disease patients. PloS One, Vol. 11, No. 8.
Frew, E., R. Cant and J. Sequeira, 2010. Capturing the data: Nutrition risk screening of adults in hospital. Nutrients, 2: 438-448.
Mayasari, M., Susetyowati and W. Lestariana, 2014. Simple Nutritional Screening Tool (SNST) has good validity to identify risk of malnutrition on hospitalized elderly patients. Pak. J. Nutr., 13: 573-578.
Susetyowati, S., B. Djarwoto and F. Faza, 2017. Nutrition screening tools as predictor of malnutrition for hemodialysis patients in Dr. Sardjito hospital in Yogyakarta, Indonesia. Saudi J. Kidney Dis. Transplant., 28: 1307-1313.
Hamada, Y., 2015. Objective data assessment (ODA) methods as nutritional assessment tools. J. Med. Invest., 62: 119-122.
Correia, M.I.T.D., 2018. Nutrition screening vs nutrition assessment: What’s the difference? Nutr. Clin. Pract., 33: 62-72.
Ghazi, H.F., M. Elnajeh, M.A. Abdalqader, M.F. Baobaid and I.A. Ariffin, 2018. Non-communicable diseases and its association with body composition and nutrition among general population in Subnag Jaya, Selangor: Community-based study. Pak. J. Nutr., 17: 255-259.
Kshatriya, G.K. and S.K. Acharya, 2016. Triple burden of obesity, undernutrition and cardiovascular disease risk among Indian tribes. PloS One, Vol. 11, No. 1.
Wells, J.C.K. and M.K. Shirley, 2016. Body composition and the monitoring of non-communicable chronic disease risk. Global Health Epidemiol. Genomics, Vol. 1.
Pierik, V.D., C.G.M. Meskers, J.M.V. Ancum, S.T. Numans and S. Verlaan et al., 2017. High risk of malnutrition is associated with low muscle mass in older hospitalized patients-A prospective cohort study. BMC Geriatrics, Vol. 17.
Endo, T., C. Momoki, M. Yamaoka, S. Hachino and S. Iwatani et al., 2017. Validation of skeletal muscle volume as a nutritional assessment in patients with gastric or colorectal cancer before radical surgery. J. Clin. Med. Res., 9: 844-859.
Chen, Z.Y., C. Gao, T. Ye, X.Z. Zuo, G.H. Wang, X.S. Xu and Y. Yao, 2015. Association between nutritional risk and routine clinical laboratory measurements and adverse outcomes: a prospective study in hospitalized patients of wuhan tongji hospital. Eur. J. Clin. Nutr., 69: 552-557.
Entezari-Maleki, T., H. Khalili, I. Karimzadeh and S. Jafari, 2015. Approach to anemia in hospitalized patients with infectious diseases; Is it appropriate? Iran. J. Pharm. Res., 14: 487-493.
Manandhar, N. and K. Bhattarai, 2018. Anemia in hospitalized patients: A cross-sectional study on different erythrocyte indices and their relationships. J. Health Sci. Res., 3: 1-10.
Hanafi, M.I., A.R. Abdallah and A. Zaky, 2013. Study of hemoglobin level and body mass index among preparatory year female students at Taibah University, Kingdom of Saudi Arabia. J. Taibah Univ. Med. Sci., 8: 160-166.
Palekar, H., C.L. Prajapati, M. Patel and J.V. Dhanani, 2015. Evaluation of change in nutritional status of patients in surgical ward after prolonged stay. Int. J. Med. Sci. Public Health, 5: 539-542.
Leandro-Merhi, V.A., V.N. Bráz and J.L.B. de Aquino, 2017. Is total lymphocyte count related to nutritional markers in hospitalized older adults? Arq. Gastroenterol., 54: 79-82.
Akner, G. and T. Cederholm, 2001. Treatment of protein-energy malnutrition in chronic nonmalignant disorders. Am. J. Clin. Nutr., 74: 6-24.
Mahakalkar, C.C., S. Modi, M. Yeola, M.N. Kaple, M.A. Patwardhan and P. Laddha, 2014. Malnutrition in hospitalised patients; a real concern in surgical outcomes. Int. J. Res. Med. Sci., 2: 250-257.
Downloads
Published
Issue
Section
License
Copyright (c) 2019 The Author(s)
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
