Studies expressing predictive validity of nutrition screening or assessment tools to predict clinical outcome
Tools developed for the elderly population
Tool / Author/year / Population / Sample size / LOS a / Ra
ting
b / Mortality a / Ra
ting
b / Complications a / Ra
ting b / Other
MNA (1994) / Martins,CPAL (2005) 10 / elderly
(≥ 65 years old) / 207 / Moderately and severely undernourished combined: LOS not significantly prolonged: OR 1.42 (95% CI 0.69-2.92) / g/f
Bauer, JM (2005) 50 / geriatric
(mean age 80.2±7.7 years old) / 121 / MNA ‘at risk’ and MNA ‘malnourished’significant longer LOS than MNA ‘well-nourished’ (p=0.044) / g
Cansado, P (2009) 51 / elderly on admission (≥ 65 years old) / 531 / MNA “at risk” or “undernutrition”: longer LOS (p=0.003) / ?
Bonilla-Palomas, JL (2011) 49 / heart failure at discharge / 208 / HR= 3.75 (95% CI 1.75-8.02) / g
Persson, MD (2002) 54 / acute geriatric
(≥ 65 years old) / 83 / long term mortality higher in malnourished patients (MNA<17 and MNA 17-23,5 combined): OR= 3.3 (95% CI 1.11–9.79) for death within 3 years / g
Vischer, UM (2012) 55 / geriatric
(≥ 75 years old) / 444 / MNA scores not significantly related to 4 y mortality HR. At risk HR 0.80 (95% CI 0.57-1.12) and ‘malnourished’ HR 0.88 (95% CI 0.58-1.33).
MNA scores not correlated to 1 y mortality / p
p
Van Nes, MC (2001) 52 / geriatric
(mean age 84.2±6.9 years old) / 1319 / MNA < 17, vs. 17-23.5, vs. ≥ 24: longer LOS, anova p<0.001 / ? / MNA < 17, vs. 17-23.5, vs. ≥ 24: in-hospital mortality, anova p<0.01 / ?
Sanchez-Munoz, LA (2010) 53 / elderly, internal medicine
(≥ 65 years old) / 106 / Malnourished patients no significantly longer LOS compared to well-nourished / p / Malnourished patients no significant difference in mortality compared to well-nourished
Donini, LM (2003) 58 / geriatric
(≥ 60 years old) / 167 / not significantly predictive of occurrence of adverse clinical events / p
Lopez-Gomez,JJ (2011) 57 / elderly medical (receiving nutritional support) (≥ 75 years old) / 113 / no relation with complications / p
Visvanathan, R (2004) 20 / geriatric
(≥ 65 years old) / 65 / Predicting poor discharge outcomes (p=0.017)
MNA-SF / Salvi, F (2008) 59 / elderly
(≥ 65 years old) / 275 / MNA-sf < 12: longer LOS (p=0.014) / ? / functional decline (OR 4.25 (1.83-9.9)
Vischer, UM (2012) 55 / geriatric
(≥ 75 years old) / 444 / MNA-sf scores not significantly related to 4 y mortality.
At risk HR 0.79 (no 95% CI given) and ‘malnourished’ HR 0.89 (no 95% CI given). MNA-sf scores not correlated to 1 y mortality / p
Raslan, M (2010) 60 / internal medicine and surgery / 705 / AUC for VLLOS: 0.62 / f / AUCfor death: 0.75 / f / AUC for complications: 0.65 / f
Putwatana, P (2005) 56 / abdominal surgery / 430 / No significant OR for postoperative complications / p
NRI / Lopez-Gomez,JJ (2011) 57 / elderly medical (receiving nutritional support) (≥ 75 years old) / 103 / no correlation with LOS / p / correlation with complications in surgical patients (p<0.05), but not with non-surgical patients / g/f / no correlation with length of nutrition
Corish, CA (2004) 33 / newly admitted ≥ 65 and < 65 years old / 359 / significant difference between outcomes NRI and NRS (p < 0.001)
Kyle, UG (2004) 61 / gastroenterology, cardiology, rheumatology, urology and general surgery / 1273 / NRI “moderately malnourished” increased LOS (p<0.05), OR 1.9 (95% CI 1.4 - 2.7)
Severely malnourished OR 2.9 (95% CI 1.6 - 5.3) / p
f
Aziz, EF (2011) 62 / acute decompensed heart failure / 1740 / predictive for LOS (OR 1.7, 95% CI: 1.58-1.9; p=0.005) / p
Kyle, UG (2006) 9 / all newly admitted adults / 995 / “high risk” longer LOS (p=0.032),
“medium risk” no longer LOS / ?
p
Filipovic, BF (2010) 63 / gastro
enterology / 299 / malnourished longer LOS (chi2, p<0.001) / ?
Schiesser, M (2009) 64 / GI surgery / 200 / NRS combined moderate/severe malnutrition longer LOS, p<0.001 / g/f / OR for developing complications in multivariate regression OR 1.7 (95% CI 0.4–8.1).
AUC for complications= 0.34 / p
p
Clugston, A (2006) 65 / obstructive jaundice, malnourished patients received nutritional support / 39 / NRI < 83.5 longer LOS (p=0.001) / g/f / NRI < 83.5, higher mortality (p=0.044) / g/f / no association with complication rate / p
GNRI / Bouillanne, O (2005) 11 / geriatric
(≥ 65 years old) / 181 / no correlation with LOS / p / OR 29 (95% CI: 5.2- 161.4) / g / For infectious complications, bed sores or both: OR 4.4 (95% CI: 1.3, 14.9)
For major nutrition related complications (GNRI<82): OR 6.6 (95% CI:1.3, 33.0)
For moderate nutrition related risk (82<GNRI<92): OR 4.9 (95% CI 1.9, 12.5)
For low nutrition related risk (92<GNRI<=98): OR 3.3 (95% CI 1.4, 8.0) / g
g
g
p / no correlation with length of nutrition
Lopez-Gomez,JJ (2011) 57 / elderly medical pts receiving nutr support
(≥ 75 years old) / 113 / no correlation with LOS or length of nutrition, / p / p / no correlation to complications / p / No correlation to length of nutrition
The development studies are printed in bold