Application and Efficacy Evaluation of Nutritional Screening Tool.
- Author:
Jung Suk YUN
1
;
Jeong Eun SHIN
;
Bong Jin KANG
;
Young Hee YANG
;
So Young KA
;
Hye Eun CHOI
;
Myung Ja AHN
;
Sun Hee HAN
;
Hwan NAMGUNG
;
Doo Sun LEE
Author Information
1. Department of Surgery, Dankook University College of Medicine, Cheonan, Korea. gsnamgung@dankook.ac.kr
- Publication Type:Original Article
- Keywords:
Nutritional screening tool;
Reliability;
Validity
- MeSH:
Arm;
Body Mass Index;
Body Weight;
Eating;
Humans;
Internal Medicine;
Length of Stay;
Lymphocyte Count;
Malnutrition;
Mass Screening*;
Mortality;
Nutrition Assessment;
Nutritional Support;
Reference Values;
ROC Curve;
Sensitivity and Specificity;
Serum Albumin;
Skinfold Thickness;
Weight Loss
- From:Journal of the Korean Surgical Society
2006;70(1):1-6
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no 'gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. METHODS: Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within 24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion for malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid- arm muscle circumference, serum albumin and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statdtatistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic (ROC) curve was drawn to choose a cutoff value that maximizes sensitivity and specificity. RESULTS: The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified 7 patients (13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. CONCLUSION: The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.
