Validity of the new nutrition screening tool Control of Food Intake, Protein, and Anthropometry (CIPA) in non-surgical inpatients

Abstract

Introduction : There is no gold-standard method for hospital nutrition screening. The new screening tool termed Control of Food Intake, Protein, and Anthropometry (CIPA) gives positive results when at least one of the following parameters is met: control of food intake for 72 h < 50%, serum albumin < 3 g/dl, body mass index < 18.5 kg/m2 or mid-upper arm circumference ≤ 22.5 cm. This method was validated in comparison with Subjective Global Assessment (SGA) in hospitalized patients with non-surgical pathologies. Material and methods: A prospective, longitudinal study was performed on 221 consecutively enrolled patients. Prevalence or risk of malnutrition was estimated with CIPA vs. SGA screening at hospital admission and the concordance ( index – K) between the two methods and their sensitivity (S) and specificity (SP) were studied. Mean length of stay (LOS), mortality, and rate of early readmission were analyzed. Results : The prevalence or risk of malnutrition identified by CIPA and SGA was 35.7% and 23.1%, respectively. K was 0.401 (p < 0.001); S and SP of CIPA vs. SGA were 72.5% and 75.3%, respectively. In contrast to SGA, CIPA-positive patients had an increased mean LOS compared to the negative ones (19.53 vs. 12.63 days, p < 0.001). Both methods detected a major risk of mortality in positive patients, but no difference in early readmission. Conclusions : The CIPA and the SGA screening tools detect patients with a higher risk of mortality, but only CIPA identifies patients with an increased mean LOS. CIPA screening proved valid for use in non-surgical inpatients.

Keywords

• malnutrition
• screening
• health care quality
• inpatient
• nutrition assessment