Comparison of Tools for Nutritional Risk Screening at Hospital Admission

Purpose: Nutritional risk screening has been emphasized to predict those patients who are malnourished or at high nutritional risk. In 2006, we developed the Seoul National University Bundang Hospital Nutrition Screening Tool (SNUBHNST) using a nutritional screening index (NSI) based on the predictors of the nutritional status. The aim of this study was to compare the SNUBH-NST and the Nutritional Risk Screening 2002 (NRS 2002) recommended by the European Society for Parenteral and Enteral Nutrition (ESPEN) as the preferred nutritional risk screening tool for hospitalized patients. Methods: Three hundred and eighty two patients hospitalized in medical and surgical wards were screened and classified as being well nourished or at nutritional risk by the SNUBH-NST and the NRS 2002 within 48 h of admission. The anthropometric measurements and laboratory data were assessed and the length of hospital stay was obtained from the medical chart. Differences between independent groups were assessed with Student's t test and the agreement between both tools was analyzed by the χ-test. Spearman's rank correlation coefficients were calculated for the correlation between the nutritional risk and the variables. Results: The SNUBH-NST and the NRS 2002 identified 14.7% and 20.9% of all the assessed patients as being at nutritional risk, respectively, and agreement was observed for 340 of the 382 (89%) patients with using both tools (κ=0.627, P<0.001). The anthropometrics and laboratory data were lower and the length of hospital stay was longer for the patients who were screened as being at nutritional risk by both tools (P<0.001). Conclusion: The nutritional risk screened by the SNUBHNST correlated significantly with age, the anthropometrics, the laboratory data and the length of stay. Agreement was substantial between the SNUBH-NST and the NRS 2002. Therefore, the SNUBH-NST can be used to screen patients who are at nutritional risk on admission. This study suggested that nutritional information and nutrition care plans should be shared with clinicians. Further studies are needed to investigate whether the SNUBH-NST can predict the clinical outcomes. (KJPEN 2009;2(1):6-12)