Validation of the Developed Nutritional Screening Tool for Hospital Patients

Jeong Sook Lee; Mi Ran Cho; Geum Ju Lee

doi:10.4163/kjn.2010.43.2.189

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Lee, Cho, and Lee: Validation of the Developed Nutritional Screening Tool for Hospital Patients

Original Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2010; 43(2): 189-196.

Published online: 30 April 2010

DOI: https://doi.org/10.4163/kjn.2010.43.2.189

Validation of the Developed Nutritional Screening Tool for Hospital Patients

Jeong Sook Lee, Mi Ran Cho, Geum Ju Lee

Nutrition Health Management Center, Kyunghee University East-West Neo Medical Center, Seoul 139-727, Korea.

To whom correspondence should be addressed. (goldwine00@hanmail.net)

Received 5 February 2010 Revised 18 February 2010 Accepted 24 February 2010

Abstract

Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGS-GA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

Keywords: nutritional screening tool, malnutrition, nutritional assessment

Figures and Tables

Table 1

Patient characteristics, anthropometric and laboratory data at hospital admission

Values are presented as mean ± standard deviation

BMI: Body mass index, Alb: Albumin, Hb: Hemoglobin, TLC: Total lymphocyte count

Table 2

Number of patients admitted to various disease and nutritional screening by KNNRS at hospital admission

Values are presented as number of subjects (%)

Table 3

Patient characteristics, anthropometric, and laboratory data by nutrition screening tool at hospital admission

Values are presented as mean ± standard deviation. KNNRS: Kyunghee Neo Nutritional Risk Screening, PG-SGA: Patient Generated-Subjective Global Assessment, NRS-2002: Nutritional Risk Screening-2002, BMI: Body mass index, Alb: Albumin, Hb: Hemoglobin, TLC: Total lymphocyte count. ^***: p < 0.000.

Table 4

Comparison of nutritional screening by PG-SGA, NRS-2002 and KNNRS at hospital admission

Values are presented as number of subjects (%)

KNNRS: Kyunghee Neo Nutritional Risk Screening, PG-SGA: Patient Generated-Subjective Global Assessment, NRS-2002: Nutritional Risk Screening-2002

^***: p < 0.00

Table 5

Statistical comparison of KNNRS and PG-SGA at hospital admission

Values are presented as number of subjects (%)

CI: Confidence interval; k statistic, percent of agreement, KNNRS: Kyunghee Neo Nutritional Risk Screening, PG-SGA: Patient Generated-Subjective Global Assessment

^**: p < 0.01

Table 6

Statistical comparison of KNNR and NRS-2002 at hospital admission

Values are presented as number of subjects (%)

^**: p < 0.01

CI: Confidence interval; k statistic, percent of agreement, KNNRS: Kyunghee Neo Nutritional Risk Screening, NRS-2002: Nutritional Risk Screening-2002

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