Clinical Interventions in Aging (Mar 2020)
Predictive Value of Nutritional Risk Screening 2002 and Mini Nutritional Assessment Short Form in Mortality in Chinese Hospitalized Geriatric Patients
Abstract
Xiaoyan Zhang,* Xingliang Zhang,* Yunxia Zhu, Jun Tao, Zhen Zhang, Yue Zhang, Yanyan Wang, YingYing Ke, ChenXi Ren, Jun Xu Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai 200233, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoyan Zhang Email [email protected] and Aim: The presence of malnutrition in hospitalized geriatric patients is associated with an increased risk of mortality. This study aimed to examine the performance of Nutritional Risk Screening 2002 (NRS2002) and Mini Nutritional Assessment Short Form (MNA-SF) in predicting mortality for hospitalized geriatric patients in China.Methods: A prospective analysis was performed in 536 hospitalized geriatric patients aged ≥ 65 years. Nutrition status was assessed using the MNA-SF and NRS2002 scales within 24 hrs of admission. Anthropometric measures and biochemical parameters were carried out for each patient. Patients were follow-up for up to 2.5 years.Results: At baseline, 161 (30.04%) patients had malnutrition/nutritional risk according to NRS2002 assessment. According to MNA-SF, 284 (52.99%) patients had malnutrition/nutritional risk. Malnutrition/nutritional risk patients had lower anthropometric and biochemical parameters (P< 0.05). NRS2002 and MNA-SF had a strong correlation with classical nutritional markers (P< 0.05). NRS2002 versus MNA-SF showed moderate agreement (kappa=0.493, P< 0.001). During a median follow-up time of 795 days (range 10– 947 days), 118 (22%) participants died. The Kaplan–Meier curve demonstrated that malnutrition/nutritional risk patients according to NRS2002 or MNA-SF assessment had a higher risk of mortality than the normal nutrition patients (χ2=17.67, P< 0.001; χ2=28.999, P< 0.001, respectively). From the components of the Cox regression multivariate models, only the NRS2002 score was an independent risk factor influencing the mortality.Conclusion: Both NRS2002 and MNA-SF scores could predict mortality in Chinese hospitalized geriatric patients. But only NRS2002 score was the independent predictor for mortality.Keywords: NRS2002, MNA-SF, elderly, nutritional screening, malnutrition