Comparison of nutritional risk screening tools for predictingsarcopenia in hospitalized patients

Comparison of nutritional risk screening tools for predictingsarcopenia in hospitalized patients

Background/aim: The aim of this study was to assess the risk of malnutrition in hospitalized patients with three different tests and to compare these tests in terms of long hospitalization periods and sarcopenia. Materials and methods: Hospitalized patients in an internal medicine clinic were enrolled in this cross-sectional study. Patients were grouped as under 65 years (Group 1 = G1) and over 65 years old (Group 2 = G2). The nutritional status of the patients was evaluated with the Nutritional Risk Screening (NRS) 2002, Universal Malnutrition Screening Tool (MUST), Mini Nutritional Assessment Short Form (MNA-SF), and total Mini Nutritional Assessment (MNA) tests. Diagnosis of sarcopenia was assessed via bioimpedance analysis for muscle mass, a hand-grip strength test, and a timed get up and go test. Nutritional tests were compared in terms of sarcopenia and long hospitalization periods with receiver operating characteristic curve analysis. Results: Mean ages were 54 (G1, n = 84) and 76 (G2, n = 112) years old. Sarcopenia was found in 5% in G1 and 33% in G2. The MNASF in G1 (area under curve (AUC) = 0.585, P = 0.26; sensitivity 41%, specificity 44%) and the MUST in G2 (AUC = 0.614, P = 0.048; 25%, 86%) were better predictors of prolonged hospitalization. The MNA-SF was associated with sarcopenia in both groups (G1: AUC = 0.716, P = 0.147; 63%, 64% and G2: AUC = 0.762, P < 0.001; 86%, 48%). In addition, the MNA-SF was a better predictor of low lean muscle mass index (AUC = 0.762, P < 0.001; 86%, 48%), low grip strength (AUC = 0.594, P = 0.27; 65%, 50%), and reduced walking speed (AUC = 0.642, P = 0.01; 71%, 47%) in G2. Conclusion: None of the three tests are highly sensitive or specific for predicting sarcopenia. The MNA-SF is a better test to evaluate sarcopenia and/or related parameters than the others, and the MUST is related to prolonged hospitalization in older patients.

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  • 1. Sieber CC. Nutritional screening tools--How does the MNA compare? Proceedings of the session held in Chicago May 2-3, 2006 (15 Years of Mini Nutritional Assessment). J Nutr Health Aging 2006; 10: 488-494.
  • 2. Thomas DR. Distinguishing starvation from cachexia. Clin Geriatr Med 2002;18: 883-891.
  • 3. Agarwal E, Miller M, Yaxley A, Isenring E. Malnutrition in the elderly: a narrative review. Maturitas 2013; 76: 296-302.
  • 4. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39: 412-423.
  • 5. Cerri AP, Bellelli G, Mazzone A, Pittella F, Landi F, Zambon A, Annoni G. Sarcopenia and malnutrition in acutely ill hospitalized elderly: Prevalence and outcomes. Clin Nutr 2015; 34: 745-751.
  • 6. Kane RL, Shamliyan T, Talley K, Pacala J. The association between geriatric syndromes and survival. J Am Geriatr Soc 2012; 60: 896-904.
  • 7. Kyle UG, Genton L, Pichard C. Hospital length of stay and nutritional status. Curr Opin Clin Nutr 2005; 8: 397-402.
  • 8. Planas M, Audivert S, Perez-Portabella C, Burgos R, Puiggros C, Casanelles JM, Rossello J. Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genoma. Clin Nutr 2004; 23: 1016-1024.
  • 9. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22: 415-421.
  • 10. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A-Biol 2001; 56: 366-372.
  • 11. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 1996; 54: 59-65.
  • 12. Stratton RJ, King CL, Stroud MA, Jackson AA, Elia M. ‘Malnutrition Universal Screening Tool’ predicts mortality and length of hospital stay in acutely ill elderly. Br J Nutr 2006; 95: 325-330.
  • 13. Ocon Breton MJ, Altemir Trallero J, Manas Martinez AB, Sallan Diaz L, Aguillo Gutierrez E, Gimeno Orna JA. Comparison of two nutritional screening tools for predicting the development of complications in hospitalized patients. Nutr Hosp 2012; 27: 701-706 (in Spanish with abstract in English).
  • 14. Drescher T, Singler K, Ulrich A, Koller M, Keller U, ChristCrain M, Kressig RW. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients. Eur J Clin Nutr 2010; 64: 887-893.
  • 15. Raslan M, Gonzalez MC, Dias MC, Nascimento M, Castro M, Marques P, Segatto S, Torrinhas RS, Cecconello I, Waitzberg DL. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients. Nutrition 2010; 26: 721-726.
  • 16. Verdich C, Barbe P, Petersen M, Grau K, Ward L, Macdonald I, Sorensen TI, Oppert JM. Changes in body composition during weight loss in obese subjects in the NUGENOB study: comparison of bioelectrical impedance vs. dual-energy X-ray absorptiometry. Diabetes Metab 2011; 37: 222-229.
  • 17. Chien MY, Huang TY, Wu YT. Prevalence of sarcopenia estimated using a bioelectrical impedance analysis prediction equation in community-dwelling elderly people in Taiwan. J Am Geriatr Soc 2008; 56: 1710-1715.
  • 18. Schutz Y, Kyle UU, Pichard C. Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y. Int J Obes Relat Metab Disord 2002; 26: 953-960.
  • 19. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, Corsi AM, Rantanen T, Guralnik JM, Ferruci LM. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003; 95: 1851-1860.
  • 20. Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the “get-up and go” test. Arch Phys Med Rehab 1986; 67: 387-389.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
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