Validation of a nutritional screening tool

Laís S Lima, Maria Antónia Araujo, Graziela C Ornelas, Maria Helida Logrado

Abstract


Background: Malnutrition is an imbalance between spending and the need of nutrients. The prevalence of hospital malnutrition is increasing according to recent studies. Several factors may contribute to the magnitude of the clinical manifestations caused by malnutrition, such as etiology and disease´s severity, duration of nutritional deficit, patient age and co-morbidities. This condition can cause increased morbidity and mortality and higher costs for healthcare resulting in longer hospital stay. Therefore, the use of a practical nutritional screening tool is important to enable early detection of nutritional risk, aiming the prevention of weight loss or it continuity, recovery of nutritional status, and achieving a better clinical outcome by adopting better nutritional interventions.

Objective: To validate the pre-screening tool for nutritional screening upon admission, during the nutritional anamnesis, and during the patient’s daily visit.

Method: Cross-sectional study with methodological character performed in the emergency room of a public hospital with 196 patients of both sexes, hospitalized, with middle age greater than or equal to 18 years. Two protocols for the assessment of nutritional risk were applied: the Subjective Global Assessment, considered the gold standard, and the Nutrition Pre-screening tool, instrument to be validated. The sample was analysed in relation to age, gender distribution and results of the PTN and ANSG.

Results and Discussion: 39% of the sample consisted of females and 61% for males. The correlation degree between the results of the screening methods according to the Kappa coefficient was 0.80. The sensitivity and specificity were 96.9% and 80.0% respectively. The positive predictive value was 90.65% and negative predictive value of 92.98%. This high correlation found, as well as the values for sensitivity, specificity and positive and negative predictive values are representative of a substantial agreement between the two screening tools.

Conclusion: Nutrition Pre-screening tool is an efficient nutritional protocol; it is fast, convenient and easily applied at any time during hospitalization.


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