A protein energy malnutrition scale (PEMS)

Area of Science:

• Nutrition Science
• Clinical Medicine
• Medical Assessment

Background:

• Traditional protein energy malnutrition (PEM) assessments rely on clinical impressions, lab tests, or anthropometrics.
• Existing methods show limitations, with clinical and laboratory approaches each misclassifying approximately 20% of patients.
• A need exists for a more comprehensive and accurate assessment tool for PEM.

Purpose of the Study:

• To introduce and validate a novel 23-item scale for assessing protein energy malnutrition (PEM).
• To evaluate the scale's reliability and its ability to discriminate between patients at risk of complications.

Main Methods:

• Development of a 23-item scale incorporating anthropometric measurements, clinical history, physical examination, and laboratory tests.
• Items rated on logarithmic scales to reflect deviation from standards.
• Reliability assessed by inter-rater agreement (r > 0.66).
• Validation through discrimination between patients with and without postoperative complications (p < 0.001).

Main Results:

• The 23-item scale provides four subscores and a total score for PEM assessment.
• High reliability was achieved with inter-rater agreement.
• The scale demonstrated significant ability (p < 0.001) to differentiate patients based on postoperative complication risk.

Conclusions:

• The developed 23-item scale offers a robust approach to assessing the degree of protein energy malnutrition.
• This scale provides a reliable method for monitoring nutritional status changes over time.
• The scale's validation suggests its utility in clinical settings for patient risk stratification.