Nutritional assessment of patients with aplastic anemia: comparison of four nutritional screening tools

Introduction: nutritional status can affect the treatment of hospitalized patients, and malnutrition can even lead to death. However, the nutritional status of patients with aplastic anemia (AA) is unclear. Objective: to assess the nutritional status of aplastic anemia patients with body mass index (BMI) ≥ 24 kg/m2 (high BMI group) and BMI < 24 kg/m2 (low BMI group), and to compare the consistency between different nutritional screening tools. Methods: patients with aplastic anemia hospitalized from January 2016 to December 2020 were collected. We used the combined index generated by Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), Control Nutritional Status (CONUT) and Instant Nutritional Assessment (INA) to assess nutritional status of patients with aplastic anemia. Kappa index was used to measure the consistency between different nutritional screening tools. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of different nutritional screening tools. Results: one hundred and ninety-five patients with aplastic anemia were enrolled. The overall prevalence of malnutrition calculated by the combined index in patients with aplastic anemia was 51.3 %. The malnutrition rates of patients in the low BMI group and high BMI group were 60.9 % and 38.8 %, respectively. The malnutrition rates of very severe aplastic anemia (VSAA) patients, severe aplastic anemia (SAA) patients and ordinary patients were 76 %, 63.8 % and 45.1 %, respectively. Compared with the combined index, NRI had the highest consistency and area under the curve. Conclusions: the nutritional status of patients with aplastic anemia was very poor; the more serious the disease, the worse the nutritional status. Although the malnutrition rate in the low-BMI group was higher than in the high BMI group, the nutritional status of overweight or obese patients can not be ignored. NRI is the best tool for assessing the nutritional status of patients with aplastic anemia.