Nutrition screening tools: Does one size fit all? A systematic review of screening tools for the hospital setting

被引:386
作者
van Bokhorst-de van der Schueren, Marian A. E. [1 ]
Guaitoli, Patricia Realino [1 ]
Jansma, Elise P. [2 ]
de Vet, Henrica C. W. [3 ]
机构
[1] Vrije Univ Amsterdam Med Ctr, Dept Nutr & Dietet, NL-1007 MB Amsterdam, Netherlands
[2] VU Amsterdam Univ Lib, Med Lib, NL-1007 MB Amsterdam, Netherlands
[3] Vrije Univ Amsterdam Med Ctr, Dept Epidemiol & Biostat, EMGO Inst Hlth & Care Res, NL-1081 BT Amsterdam, Netherlands
关键词
Screening; Assessment; Construct validity; Predictive validity; Malnutrition; Hospital; Systematic review; SUBJECTIVE GLOBAL ASSESSMENT; ASSESSMENT-SHORT-FORM; LENGTH-OF-STAY; 2002; NRS; RISK INDEX; CLINICAL-OUTCOMES; PROGNOSTIC-SIGNIFICANCE; ASSESSMENT MNA; ASSESSMENT SGA; MALNUTRITION;
D O I
10.1016/j.clnu.2013.04.008
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aims: Numerous nutrition screening tools for the hospital setting have been developed. The aim of this systematic review is to study construct or criterion validity and predictive validity of nutrition screening tools for the general hospital setting. Methods: A systematic review of English, French, German, Spanish, Portuguese and Dutch articles identified via MEDLINE, Cinahl and EMBASE (from inception to the 2nd of February 2012). Additional studies were identified by checking reference lists of identified manuscripts. Search terms included key words for malnutrition, screening or assessment instruments, and terms for hospital setting and adults. Data were extracted independently by 2 authors. Only studies expressing the (construct, criterion or predictive) validity of a tool were included. Results: 83 studies (32 screening tools) were identified: 42 studies on construct or criterion validity versus a reference method and 51 studies on predictive validity on outcome (i.e. length of stay, mortality or complications). None of the tools performed consistently well to establish the patients' nutritional status. For the elderly, MNA performed fair to good, for the adults MUST performed fair to good. SGA, NRS-2002 and MUST performed well in predicting outcome in approximately half of the studies reviewed in adults, but not in older patients. Conclusions: Not one single screening or assessment tool is capable of adequate nutrition screening as well as predicting poor nutrition related outcome. Development of new tools seems redundant and will most probably not lead to new insights. New studies comparing different tools within one patient population are required. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
引用
收藏
页码:39 / 58
页数:20
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