Abstract:ObjectiveTo study the consistency of NRS 2002 and MNA-SF nutritional screening scales in assessing the risk of malnutrition in elderly clinical bed patients, and to provide a basis for guiding nutritional intervention in elderly bedridden patients. Methods Using NRS 2002 and MNA-SF nutritional screening tools to evaluate the nutritional status of 120 patients within 24 hours of admission. The results were compared with the nutritional indicators obtained by anthropometric and biochemical tests. Kappa analysis was used to test the consistency of the two nutritional evaluation methods in evaluating malnutrition. ResultsThe incidence of malnutrition in the NRS 2002 was 68.3%, and the MNA-SF was 63.3%. The risk of malnutrition increased with the age increasing, the difference was statistically significant (P<0.05); Hb, TP, PA, and TLC values decreased accordingly within the occurred of malnutrition. Assessing the consistency rate of malnutrition in elderly bedridden patients was 90%(108/120) with two nutritional evaluation tools of NRS 2002 and MNA-SF, the value of Kappa was 0.778,and the value of 95% CI was 0.655~0.890,P<0.001.ConclusionNRS 2002 and MNA-SF, two nutrition screening scales , have a high consistent rate of malnutrition in elderly bed patients. Both of them can be used to evaluate malnutrition in elderly bed patients on admission, providing a basis for early clinical nutrition treatment.
沈晗,孙金华,胡杰. 两种营养评估表应用于老年卧床住院患者的一致性评价[J]. 肿瘤代谢与营养电子杂志, 2019, 6(4): 447-450.
SHEN Han, SUN Jin-hua, HU Jie. Two nutrition screening scales to evaluate the consistency of assessing malnutrition in elderly hospitalized patients in bed. Electron J Metab Nutr Cancer, 2019, 6(4): 447-450.
1.Kaiser MJ, Bauer JM, Ramsch C, et al. Frequency of malnutrition in order adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58(9):1734-1738.
2.陈禹,李晓雯,林兵,等. 老年住院患者营养风险筛查和营养状况分析. 中国食物与营养. 2014;20(2):81-84.
3.何杨利,蹇在金,欧阳敏,等. 老年卧床不起患者营养状况的调查. 中国老年学杂志. 2008;28(15):1517-1518.
4.沈伟慧. 老年卧床患者营养状况及影响因素调查分析与管理对策. 中医药管理杂志. 2014;22(11):1906-1908.
5.Pezzana A, Cereda E, Avagnina P, et al. Nutritional care needs in elderly residents of long-term care institutions: potential implications for policies. J Nutr Health Aging. 2015;19(9):947-954.
6.中华医学会肠外肠内营养学分会老年营养支持学组. 老年患者肠外肠内营养支持中国专家共识. 中华老年医学杂志. 2013;32(9):913-929.
7.蒋朱明,陈伟,朱赛楠,等.我国东、中、西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查.中国临床营养杂志. 2008;16(6):335-337.
8.方仕, 麦海妍, 卢味,等. 住院患者营养风险筛查及营养支持状况. 中国公共卫生. 2010;26(5):574-575.
9.张片红, 朱心强, 何芳,等. 浙江省住院患者营养风险筛查及营养支持状况分析. 营养报. 2011;33(1):84-86.
10.简荣汉, 苏葵花,张敏,等. 老年科住院病人营养风险筛查及营养支持状况的研究. 肠外与肠内营养. 2013;20(2):81-86.
11.Kondrup J,Rasmussen H, Hamberg O,et al. Nutritional risk screening(NRS 2002): a new method based on all analysis of controlled clinical trials.Clin Nutr. 2003;22:321-336.
12.中华医学会肝病学分会,中华医学会消化病学分会. 终末期肝病临床营养指南. 实用肝脏病杂志. 2019;22(5):624-635.
13.王秋梅,陈伟,宋长城,等. MNA和NRS 2002 对老年住院患者营养评估的比较. 中华老年多器官疾病杂志. 2014;13(7):528-531.
14.张燕,王利仙,吕晓华,等. 微型营养评估简表在老年慢性病住院患者营养筛查中的应用. 中华老年多器官疾病杂志. 2019;18(2):107-111.
15.Neelemaat F, Meijers J, Kruizenga H, et al. Comparison of five malnutrition screening tools in one hospital inpatient sample. J Clin Nurs. 2011;20(15/16):2144-2152.
16.龚丽青,刘妮,王艳莉,等. NRS 2002与PG-SGA在肿瘤患者中的应用和比较. 肿瘤代谢与营养电子杂志. 2018;5(2):151-154.
17.潘洁,崔红元,朱明炜,等. 老年患者住院和出院时营养风险和应用量表的营养不良检出率多中心对比调查研究. 中华临床营养杂志. 2019;27(2):65-69.
18.朱海英,于常英.老年住院患者营养风险、营养不良(不足与超重)发生率及营养支持现状. 中国老年学. 2012;32(10):2057-2059.
19.刘晔,欧阳晓俊,蔡晓真,等. 内科老年住院患者营养状况及其影响因素分析. 中国临床保健杂志. 2019;22(2):174-178.
20.毕研霞,洪忠新,张立红,等. 两种营养筛查方法在神经内科老年住院患者中的应用. 中国食物与营养. 2017;23(3):76-80.
21.张晓峰,苏宁,贾若平,等. 总体主观评价法和微型营养评价精法在老年肿瘤患者营养评估中的比较. 中国慢性病预防与控制. 2014;22(3):323-325.
22.Salvà Casanovas A. The mini nutritional assessment. twenty years contributing to nutritional assessment. Rev Esp Geriatr Gerontol. 2012;47(6):245-246.
23.陈伟,王朝琴,黄宗谭,等. 两种营养评价方法在老年脑出血患者营养筛查中的应用. 中华老年医学杂志. 2016;35(8):820-823.
24.Raslan M, Gonlez MC, Torrinhas RS, et al. Complementarily of subjective global assessment (SGA) and nutritional risk screening 2002 (NRS 2002) for predicting poor clinical outcomes in hospitalized patients. Clin Nutr. 2011;30(1):49-53.
25.廖丽萍,赵艳,王玲,等.修订版MNA-SF与传统MNA在老年住院患者营养状况评估中与传统营养指标相关性分析.中国继续医学教育. 2017;8(35):181-183.
26.Eglseer D, Halfens R, Lohrmann C. Is the presence of a validated malnutrition screening tool associated with better nutritional care in hospitalized patients? Nutrition. 2017;37:104-111.
27.Drescher T, Singler K, Ulrich A, et al. 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(8):887-893.
28.Phillips MB, Foley AL, Barnard R, et al. Nutritional screening in community-dwelling older adults: a systematic literature review. Asia Pac J Clin Nutr. 2010;19(3):440-449.
29.严凤琴, 朱虹, 段晓字,等. 营养评定工具NRS 2002、MNA和实验室检查在老年住院病人营养调查中的应用. 肠外与肠内营养. 2016;23(6):369-372.
30.Van Bokhorst-de van der Schueren MA, Guaitoli PR, Jansma EP, et al. Nutrition screening tools: does on size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr. 2014;33(1):39-58.