| Objectives:The nutritional screening module derived from the Chinese version of the International Resident Assessment tool(interRAI-PAC)was applied to inpatient stroke patients.Comparing to the Nutrition Screening Scale(NRS-2002)with the purpose to investigate the application value of the two nutritional screening methods in the nutritional screening for stroke patients,to provide the guidance for clinical treatments and prevention of malnutrition in stroke patients,and to offer some scientific base for the clinical application of the Chinese version of interRAI-PAC in China.Methods:This study collected 109 eligible and newly admitted stroke patients at the inpatient department of the Rehabilitation Medicine Department of the Second Affiliated Hospital of Kunming Medical University,from June 2020 to January 2021.The patientss’ general information,NRS-2002 and interRAI-PAC were acquired and completed after obtaining the informed consents.The nutrition-related serum biochemistry,anthropometric indicators,and clinical outcome indicators such as complications,hospitalization duration,hospitalization expenses were also recorded.Results:1.Two nutritional screening methods were used to screen and evaluate the nutritional status of 109 stroke patients.The proportion of patients with nutritional risks detected by NRS-2002 was 65.1%(71/109),and the average age of patients in the nutritional risk group and the non-nutrition risk group was 62.10 ± 12.74 and 56.53±12.31 respectively.The age difference between the two groups was statistically significant(p<0.05).The proportion of patients with malnutrition(or at risks)assessed by the nutritional screening module derived from the interRAI-PAC was 58.7%(64/109).The average age of patients in the malnutrition(or at risks)group and the normal nutrition group was 61.02±12.59 and 58.93±13.17.The age difference between these two groups was not statistically significant.2.Taking NRS-2002 as the golden standard,the sensitivity of the interRAI-PAC nutrition screening module for nutrition screening was 77.46%,specificity was 76.32%,positive predictive value was 85.94%,negative predictive value was 64.44%,and Youden index was 53.78%.The Kappa value of the consistency test of the two nutrition screening methods was 0.516(p<0.001),The screening results were moderately consistent,and the consistency rate of the test was 77.06%.3.According to the NRS-2002 grouping results,the ALB,PAB,Hb,TC,BMI,MAC and CC of the nutritional risk group were lower than those in the non-nutrition risk group(P<0.05).TLC and TSF in the nutritional risk group were also lower than those in the no nutritional risk group,but the difference was not statistically significant(p>0.05).4.According to the results of the nutritional screening module of interRAI-PAC,the ALB,PAB,Hb,BMI and TSF of the trigger group were lower than those in the non-triggered group(p<0.05).TC,TLC,MAC,and CC in the trigger group were also lower than those in the non-triggered group,but the difference was not statistically significant(p>0.05).5.The complication rate and hospitalization expenses of the patients in the nutritional risk or the malnutrition group were higher than those in the nom-nutrition risk or the normal nutrition group,and the difference was statistically significant(p<0.05).On the other hand,the length of hospitalization showed no statistical difference in the grouping results of the two screening methods(p>0.05).6.Taking the occurrence of complications in stroke patients as the reference standard,the sensitivity and specificity of the NRS-2002 scale were 86.96%and 50.79%respectively,and the Youden index was 37.75%.The sensitivity and specificity of the nutritional screening module of interRAI-PAC were 71.74%and 52.38%respectively,and the Youden index was 26.29%.The area under the curve(AUC)of the ROC curve of the predictive value of the two nutritional screening methods for complications were 0.703 and 0.632,respectively.Conclusions:1.The nutritional screening module of interRAI-PAC and NRS-2002 have a certain application value for nutritional screening of stroke inpatients.2.The NRS-2002 is superior to the interRAI-PAC nutritional screening module in the predictive value of complications.However,in addition to nutritional screening,interRAI-PAC can also detect other clinical problems timely in patients with stroke.Intervention in advance can improve the clinical outcome in those patients,and it would have better fit applicable value in the overall clinical management.3.The incidence of malnutrition and nutritional risks in stroke inpatients is high as the older the patient gets,the worse the nutritional status turns. |
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