![]() ![]() The methods tested scored malnutrition at different frequencies. Screening and assessment of nutritional status should be integrated into clinical routine. Malnutrition seems to be a common diagnosis among hospitalised patients in Austria. ![]() Cancer patients had the worst nutritional status. Severe malnutrition was detected in 0.5% (BMI), 9.1% (PNRA), 5.2% (NRI) and 11.4% (INS) of the patients evaluated. Patients were variously diagnosed with moderate malnutrition: 9% (BMI), 42% (PNRA), 54.8% (NRI) and 30% (INS). The BMI showed 90.2% of the patients evaluated to have normal nutritional status, whereas the PNRA identified 48.9%, the NRI 40% and the INS 58.6% as well nourished. Four recommended methods, the Innsbruck nutrition score (INS), the Prideaux nutritional risk assessment (PNRA), the well established nutrition risk index (NRI), and the body mass index (BMI) were used to analyse nutritional status. In this study a comparison of four different methods for diagnosis of the nutritional status of patients admitted to a university hospital in Austria is presented.Ĭlinical data of 640 hospitalised patients were analysed in a prospective-descriptive study design. In this article, the authors present a critical review on the clinical relevance of the methods of nutritional assessment more commonly used in clinical practice and, moreover they discuss the more recently proposed systems for scoring the severity of illness.ĭespite intense clinical research, no commonly accepted diagnostic tool for assessment of nutritional status is yet available. In fact, they could be used for the following purposes: (a) a more correct stratification of patients in clinical studies (b) monitoring the evolution of the infectious complication (c) prediction of survival (d) optimization of the criteria for admission to and discharge from intensive care units and (e) evaluation of quality, quantity, and costs of nutritional therapy in critically ill patients. Systems for scoring the severity of illness are of critical importance in hospital practice and clinical research. Nevertheless, the majority of these studies do not take into consideration the severity of infectious episodes. Several studies have attempted to define nutritional parameters that can be used to select undernourished hospitalized patients and identify those who present higher risk of postoperative septic complications. #Prideaux nutritional assessment tool trialHowever, a prospective and randomized clinical trial is needed to evaluate the reliability of the INST. Due to enhanced specificity the instrument may help to make screening for nutritional risk easier in clinical practice. The Innsbruck Nutrition Screening Tool (INST) was now tested for the first time. As the original NRS 2002 seemed to be too complex for clinical practice we modified the initial screening test of the NRS 2002 in order to enhance practicability. Discussion and conclusion: In order to implement nutritional screening in daily clinical practice not only validity but also practicability is essential. Sensitivity was calculated as 73,3%, 36,3% and 21,9% whereas specificity was calculated as 56,9%, 88,2% and 98,3% respectively. In dependence of the cut-off-value chosen the INST classified 73,3%, 26,3% and 21,9% of the patients to be at nutritional risk. Further analysis revealed sensitivity of 98 % and specificity of 53 % in the detection of nutritional risk. Results: According to the results of the initial NRS screening test 70,3 % of the patients were at nutritional risk. The final screening test of the NRS 2002 served as reference method to define nutritional risk. Patients and methods: INST and the initial screening of the Nutritional Risk Screening 2002 (NRS 2002) were used for retrospective analysis of the nutritional risk of 640 patients included in a clinical trial published back in 2004. The aim of this pilot study was to analyze the practicability of the Innsbruck Nutrition Screening Tool (INST) in detecting patients at risk for malnutrition. Nevertheless, it still remains unclear which screening tool is best for the use in daily clinical practice. As a consequence the Council of Europe passed a resolution concerning malnutrition in european hospitals in 2003 and the European Society for Parenteral and Enteral Nutrition (ESPEN) published guidelines on screening of nutritional status. According to the results of european studies the prevalence of malnutrition among hospitalized patients ranges between 20 and 60%. ![]()
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