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Chirurgie 1. Juni 2012

Assessment of the nutritional status of surgical inpatients using two different screening tools

BACKGROUND: Despite the fact that malnutrition in patients is known to be frequently encountered and to be of critical importance, affecting substantially morbidity and mortality, screening for nutritional status is not yet standardized upon admission in many hospitals. There is a multitude of screening tools available, allowing to identify patients at risk. We wanted to assess the frequency of malnutrition in our patients, identify common risk factors and establish a viable screening method. Therefore, we compared two different screening tools. METHODS: For this prospective, descriptive, non-randomized study, 634 consecutive patients of five surgical departments underwent as well the nutrition risk screening test as the Innsbruck nutrition screening tool. The nutrition risk screening test that is recommended by the European Society for Clinical Nutrition and Metabolism was used as reference test. RESULTS: The nutrition risk screening test identified 18.2% to be malnourished. The Innsbruck nutrition screening tool identified 8.9% of all patients to be malnourished (specificity 98.8%, sensitivity of 43.9%). Gastrointestinal disease, malignant disease and gastrointestinal malignoma as well as female sex proved to be risk factors in our study cohort. CONCLUSIONS: Our study confirms malnutrition to be common at our hospital. The use of screening tests proved to be essential to identify malnourished patients. The comparison of INST and NRS 2002 revealed that the INST might be more practicable due to a higher specificity (98.8%). On the other hand 56% of all malnourished patients are not detected due to low sensitivity if Innsbruck nutrition screening tool is used.

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