Original Title: Validación de un método de detección precoz de la desnutrición hospitalaria

Authors' objectives: This study consists of two parts. Firstly, a systematic review to select the best universal malnutrition screening tool. On the other hand, a validity study and a prevalence study on the hospital undernourishment

Authors' results and conclusions: 368 patients were included in the study. 58,2% were female. And the age average was 61,7 (DS=17,2). 48,6% were medical patients and 51,4% surgical patients. CONUT in front of NRS-2002, presents 79% of sensibility and 59,7% of specificity; the predictive positive value was 47,7 and the predictive negative value was 86,0. The agreement between observers (nutritionist vs nurse) using NRS-2002 was 78,5% (K=0,41) which is preserved along consecutive evaluations (2nd: 78,3 and K = 0,52; 3rd: 75,8 and K = 0,48). Using NRS-2002 the risk of malnutrition affects to the 31,5% of patient on admission and 52,6% using CONUT (39,3% light risk, 10,3% moderate and 3% severe). CONCLUSIONS There is not a gold standard tool to evaluate malnutrition risk in hospitalized patients. NRS-2002 shows some limitations: doubtable appropriateness to use in elderly; agreement between nutritionists and nurses is not enough for patients in risk and requires much training. Although its limitations (low specificity and high number of false positives), CONUT can be used as a screening tool in the general hospitals for its applicability, objectivity and low cost.

Authors' recommendations: It is necessary to keep making researches to improve the inpatient nutrition, and mainly, to make randomized clinical trials who demonstrate the association between nutrition status and morbimortality and length of stage.

Authors' methods: Systematic review. Validity studies in the last ten years (1997-2006). Key words: Malnutrition/ undernutrition/nutritional assessment & hospital & validity. Sensibility or specificity > 60%. As a result 17 articles and two tools were selected (CONUT in its screening stage and NRS-2002) to make the validity and prevalence studies. Validity and prevalence. Consecutive selection of patients in their admission in medical or surgical services of two Osakidetza’s (Basque Healht Service) General Hospitals until the sample was obtained. Albumin, lymphocyte count and cholesterol analytics were determined in all patients on admission, as CONUT screening tool proposes. In the first 24 hours of admission the nurse assessed the risk of malnutrition with NRS-2002 and in the next 24h-48h the patient was assessed by a nutrition expert, who was blind to the nurse’s assessment.

Project Status: Completed

Year Published: 2012

URL for published report: https://www.euskadi.eus/contenidos/informacion/2012_osteba_publicacion/es_def/adjuntos/osteba_D-12-05%20desnutrici%C3%B3n%20hospitalaria.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>