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Original Articles
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Development of Nutrition Screening Index for Hospitalized Patients
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Suan Kim, Soyeon Kim, Cheongmin Sohn
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Korean J Community Nutr 2006;11(6):779-784. Published online December 31, 2006
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Abstract
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- Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients, few valid screening instruments for Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than 18.5 kg/m2, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.
- [English]
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Development of a Simple Screening Test for Identifying Korean Elderly at Risk of Undernutrition
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Ki Nam Kim, Taisun Hyun, Joung Won Lee
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Korean J Community Nutr 2000;5(3):475-483. Published online September 30, 2000
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Abstract
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- The develop a simple screening test for identifying Korean elderly at risk of undernutrition, the data of the health-related habits, dietary behaviors and nutrient intakes of the elderly in Chongju were analyzed. Two risk indicators, mean adequacy ratio (MAR) and the respondents perceived health, were used to detect the undernutrition risk of the elderly. In order to select a list of questions for the test, factors a affecting nutritional status and items investigated in previous nutrition surveys of the elderly were considered, and 21 questions were primarily selected. A multiple regression and stepwise regression analysis were used to take out the weak predictors of poor nutrient intake, and to give item weights to the strong predictors, and a list of 17 questions was finally adopted. To determine the cut-point of the test score, sensitivity, and positive predictive values were calculated. The Simple Screening Test developed in this study is a brief, easily scored tool to predict poor nutrient intake and the perceived health status of the elderly. The test may provide a basis of further comprehensive nutritional assessment or intervention planning, if necessary, for those who are diagnosed ad "high risk". The test, however, needs to be independently validated by other groups of individuals.
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