[Comparison of two nutritional screening tools for predicting the development of complications in hospitalized...

The prevalence of malnutrition in hospitalized patients is high and has been associated with higher morbimortality. Currently no nutritional screening tool is considered the gold standard for identifying nutritional risk. The aims of this study were to evaluate the prevalence of nutritional risk in hospitalized patients using the nutritional screening tools Mini Nutritional Assessment (MNA) and Nutrition Risk Screenig 2002 (NRS 2002) and to identify the ability for predicting development of complications.

We evaluated 57 patients admitted within the first 48 h in different medical or surgical wards of the hospital. The patients were assessed by MNA and NRS 2002 and using anthropometric and laboratory parameters. Agreement between MNA and NRS 2002 was analyzed with the kappa index. ROC curves were used for assessing the validity of the both tools in predicting complications with determination of the area under the curve (AUC).

The prevalence of patients at nutritional risk was 38.6% with the NRS-2002 and 49.1% with the MNA. The agreement between two tools was moderate (κ = 0.436, p = 0.001). The incidence of complications was significantly higher in patients at nutritional risk defined by the NRS 0,002) but not according to the MNA (28.6% vs. = 2002 (40.9% vs. 5.7%; p 0.08). Sensitivity for predicting complications was 81.8% with = 10.3%, p the NRS 2002 and 72.7% with the MNA and specificity was 71.7% and 56.5% respectively. By ROC curve, both tests were valid to identify the risk of complications: NRS 2002 AUC = 0.768 (confidence interval (IC) 95%: 0.637-0.869) and MNA AUC = 0.646 (IC 95%: 0.508-0.768), but the AUC was significantly higher with the NRS 2002 (p = 0.047).

The prevalence of nutritional risk in hospitalized patients is high. NRS 2002 is a screening tool more valid than MNA to predict the development of complications.