Evaluation of different screening tools for detection of malnutrition in hospitalised patients.
Regina Cortes, Aina M Yañez, Laura Capitán-Moyano and 2 others
PMID 38629350WHAT IT FOUND
Using the ESPEN malnutrition definition, 20.2% of hospitalised patients were malnourished.
MUST was the best overall screen, but it required usual weight; MNA-SF caught nearly all older patients but flagged many false alarms.
Key findings
01By ESPEN criteria, 50 patients had malnutrition and prevalence was 20.2%.
02MUST had the highest sensitivity (80.0%), specificity (74.7%), and positive predictive value (44.4%) among tools applicable to all patients.
03MNA-SF had high sensitivity (94.4%) but low specificity (39.0%) in patients older than 65 years (n = 172).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis included 248 of 338 enrolled patients; 90 were excluded because usual body weight was unknown or missing, so results may not apply to patients without weight history. It was a single-centre internal medicine study at one Spanish hospital, so accuracy may differ in surgery, critical care, community, or other countries. The planned sample size was 323 patients, but 248 were analysed. Malnutrition prevalence changed by definition: 20.2% by ESPEN, 33.9% by SGA, and 50.0% by GLIM. Patients with dementia who were unaccompanied and did not consent were not included, so malnutrition prevalence in that group is unknown. GLIM was modified by replacing reduced food intake or assimilation with reduced appetite, so it was not tested exactly as published. One researcher performed all clinical evaluations, which may reduce measurement variability but also introduces single-observer assessment.
Declared interests
Funded by the Health Research Institute of the Balearic Islands (IdISBa) under grant PRI21/08; authors declare no potential conflicts.
The easy way to misread this
Do not conclude MUST is the best screening tool for every hospital admission. It could not be scored for 26.6% of initially enrolled patients because usual body weight was missing. Also do not treat albumin, lymphocytes, cholesterol, or CRP as reliable markers of malnutrition, because they did not differ between malnourished and well-nourished patients.