Journal List > J Nutr Health > v.47(2) > 1081330

J Nutr Health. 2014 Apr;47(2):124-133. Korean.
Published online April 30, 2014.
© 2014 The Korean Nutrition Society
Development of a simplified malnutrition screening tool for hospitalized patients and evaluation of its inter-methods reliability
Oak Hee Yun,1,2,§ Gyuhwi Lee,3,§ and Yoon Jung Park3
1Department of Clinical Health Sciences, Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 120-750, Korea.
2Nutrition Team, Korea Institute of Radiological and Medical Sciences, Seoul 139-709, Korea.
3Department of Nutritional Sciences & Food Management, College of Health Sciences, Ewha Womans University, Seoul 120-750, Korea.

To whom correspondence should be addressed. tel: +82-2-3277-3092, Email:

§These authors contributed equally to this work.

Received January 02, 2014; Revised February 11, 2014; Accepted March 31, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospi-talized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002.


Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGS-GA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hema-tocrit, and changes in body weight and food intake, were statistically selected as variables for SMST.


Accord-ing to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, κ = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, κ = 0.505), respectively, indicating that SMST held high inter-methods reliability.


In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

Keywords: nutrition screening; malnutrition; nutritional status; hospitalized patients


Table 1
Patient characteristics based on an anthropometric and laboratory data
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Table 2
Relationship between normal and malnutrition by PGSGA
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Table 3
Selection of variations in developing a new tool for the Simplified Malnutrition Screening Tool (SMST)
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Table 4
Logistic regression analysis of the variables for SMST model
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Table 5
Inter-methods Reliability of the SMST index
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Table 6
Patient characteristics by SMST
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Table 7
Statistical comparisons of PGSGA, NRS2002 and SMST at admission
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This work was supported by grants from the National Research Foundation of Korea funded by the Korea government (MEST)(2012018819) and Brain Korea 21 Plus (22A20130012143).

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