| Objective: To assess malnutrition risk in geriatric patients with two different tests [Nutritional Risk Screening(NRS2002) and Mini-Nutritional Assessment(MNA)] and nutritional biochemical parameters, to compare them in terms of a variety of methods, in order to identify the most appropriate nutritional screening tool for these patients. Method: A total of 138 elderly Chinese inpatients were enrolled in this cross-sectional study from December 2013 to July 2015. Nutritional status was assessed by NRS2002, MNA, anthropometric measurements and biochemical parameters within 24 hours of admission. Comorbidities and length of hospitalization were recorded. Nutritional parameters and length of hospital stay were used to compare MNA and NRS2002. Besides, Kappa analysis was used to evaluate the consistency of the two tools. Result: The average age was 81.02±6.92 years(range, 65-98) and 28.3% were females. The average body mass index was 23.58±4.07 kg/m2(range, 11.09-34.14). The prevalence of undernutrition classified by body mass index, albumin, prealbumin, hemoglobin, total lymphocyte count were 11.59%, 19.57%, 44.20%, 32.61%, 38.41%, respectively. The MNA showed that 21 patients(15.21%) were malnourished, 49 patients(35.51%) were at risk of malnutrition and 68 patients(49.28%) had a normal nutritional status. According to the NRS2002, about 29 patients(21.01%) were under-nourished, 109 patients(78.99%) were at normal nutritional status. The incidence of malnutrition was increased as the age increased(P < 0.001). Patients with malnutrition had lower BMI, hemoglobin, albumin and prealbumin(p<0.05), and longer length of hospital stay(p<0.05). The NRS2002 showed fair agreement(κ=0.325, p<0.001) with MNA. Both tools showed significant correlation with classical nutritional markers(p<0.05) except for total lymphocyte count(p>0.05). In addition, a significant association between MNA and length of hospital stay was found(p<0.05). Conclusion: The results show a relatively high prevalence of malnutrition among elderly inpatients in our sample cohort, and illustrate the differences in nutritional risk detected by different screening tools. The incidence of malnutrition was increased with the increase of age. Compared with well-nourished patients, patients with malnutrion have lower nutritional parameters. The NRS2002 and MNA, in fair agreement with each other, were consistently associated with age, BMI, Hb, ALB and PAB. The MNA identified more patients with or at risk of malnutrition than did the NRS2002. Besides, the MNA was found to be a good predictor of the length of hospitalization. Therefore, this study suggests MNA may be the appropriate tool to screen malnutrition risk among geriatric inpatients. |
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