Journal List > J Nutr Health > v.52(4) > 1136441

J Nutr Health. 2019 Aug;52(4):332-341. Korean.
Published online Aug 28, 2019.
© 2019 The Korean Nutrition Society
Validation of initial nutrition screening tool for hospitalized patients
Hye-Suk Kim,1,2 Seonheui Lee,1,3 Hyesook Kim,4 and Oran Kwon1,4
1Department of Clinical Nutrition Science, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 03760, Korea.
2Department of Clinical Nutrition, Catholic Kwandong University, International ST, Incheon 22711, Korea.
3Samsung Medical Center Nutrition Management Part, Seoul 06351, Korea.
4Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea.

To whom correspondence should be addressed. tel: +82-2-3277-6860, Email:
Received Apr 05, 2019; Revised Jun 17, 2019; Accepted Jun 20, 2019.

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.



Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared.


Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool.


The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools.


This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

Keywords: nutritional support; nutrition screening tool; validation


Table 1
Patient characteristics based on an anthropometric and laboratory data at hospital admission (n = 686)
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Table 2
Diagnosis department by CKUNRS at hospital admission (n = 686)
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Table 3
Patient characteristics by CKUNRS and PG-SGA at hospital admission (n = 686)
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Table 4
Correlation of anthropometrics and laboratory data and nutritional risk by CKUNRS and PG-SGA at hospital admission
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Table 5
Comparison of nutritional risk by CKUNRS and PG-SGA at hospital admission
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Table 6
Statistical comparison of CKUNRS and PG-SGA at hospital admission
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