The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture

Journal of Human Nutrition and Dietetics - Tập 26 Số 6 - Trang 519-526 - 2013
Jack Bell1,2, Judith Bauer1, Sandra Capra1
1Centre for Dietetics Research, School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia
2Department of Nutrition and Dietetics, The Prince Charles Hospital, Queensland Health, Brisbane, Queensland, Australia

Tóm tắt

AbstractBackgroundThe Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit.MethodsData were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) < 22 kg m–2, or MUAC < 25 cm] was compared with malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10‐Australian Modification (ICD10‐AM) coding criteria.ResultsMalnutrition prevalence was 37.5% using ICD10‐AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28).ConclusionsIn this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under‐diagnosis and treatment of malnutrition, leading to case‐mix funding losses.

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Tài liệu tham khảo

10.1016/j.clnu.2011.08.002

10.1007/s12603-011-0098-1

10.1111/j.1747-0080.2007.00179.x

10.3390/ijerph8020514

10.1016/j.injury.2007.01.001

10.1093/ajcn/34.11.2530

10.1016/j.ijcard.2007.12.047

10.1016/j.jamda.2010.11.013

10.1016/j.mcna.2011.02.004

10.1111/j.1747-0080.2009.01383.x

10.1177/014860718701100108

10.1007/BF03324641

Elia M., 2003, Screening for Malnutrition: A Multidisciplinary Responsibility. Development and Use of the Malnutrition Universal Screening Tool (MUST) for Adults

10.1097/MCO.0b013e328348ef51

10.1016/j.nut.2011.11.009

10.1016/S0899-9007(99)00084-2

10.1111/j.1747-0080.2010.01465.x

10.1111/j.1747-0080.2010.01422.x

10.1111/j.1747-0080.2009.01372.x

10.1016/j.clnu.2011.01.011

10.1016/j.clnu.2007.06.003

10.1111/j.1365-277X.2009.01008.x

10.1016/j.gerinurse.2008.02.010

10.1111/j.1532-5415.2009.02377.x

10.1007/s12603-009-0214-7

10.1016/S0261-5614(03)00098-0

10.1016/S0261-5614(02)00214-5

10.2307/2529310

Malnutrition Advisory Group., 2003, The ‘MUST’ Explanatory Booklet. A Guide to the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for Adults

10.1017/S0007114508076289

10.1111/j.1747-0080.2011.01538.x

10.1002/jhm.811

10.1177/0148607110389335

National Centre for Classification in Health., 2006, The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD‐10‐AM): Tabular List of Diseases

National Institute for Health and Clinical Excellence (NICE).(2006)Nutrition Support in Adults: Oral Nutrition Support Enteral Tube Feeding and Parenteral Nutrition. Clinical guideline 32. Available at:http://www.nice.org.uk/nicemedia/live/10978/29981/29981.pdf(accessed on 12 January 2011).

10.1093/gerona/glq227

10.1016/S0261-5614(03)00009-8

Roberts R.F., 1998, Introducing ICD‐10‐AM in Australian hospitals, Med. J. Aust., 169, S32, 10.5694/j.1326-5377.1998.tb123473.x

10.1016/j.anclin.2009.07.009

Thomas B., 2007, Manual of Dietetic Practice

10.1017/S0007114510003429

10.1097/01.NCQ.0000347449.83052.1a

10.1038/ejcn.2010.243

10.1016/j.gtc.2009.06.009

10.1111/j.1365-277X.2009.00971.x

10.1007/s11606-007-0429-4

10.1093/gerona/glq100

10.1136/bmj.a2390

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Journal of Human Nutrition and Dietetics

Tập 26 Số 6

519-526

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