Nutritional Risk in Emergency‐2017: A New Simplified Proposal for a Nutrition Screening Tool

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 42; no. 7; pp. 1168 - 1176
• Main Authors: Marcadenti, Aline, Mendes, Larissa Loures, Rabito, Estela Iraci, Fink, Jaqueline da Silva, Silva, Flávia Moraes
• Format: Journal Article
• Language: English
• Published: United States 01-09-2018
• Subjects: emergency service; length of hospital stay; malnutrition; mortality; nutrition screening; length of hospital stay; mortality; malnutrition; emergency service; nutrition screening
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1002/jpen.1147

Background
There are many nutrition screening tools currently being applied in hospitals to identify risk of malnutrition. However, multivariate statistical models are not usually employed to take into account the importance of each variable included in the instrument's development.
Objective
To develop and evaluate the concurrent and predictive validities of a new screening tool of nutrition risk.
Methods
A prospective cohort study was developed, in which 4 nutrition screening tools were applied to all patients. Length of stay in hospital and mortality were considered to test the predictive validity, and the concurrent validity was tested by comparing the Nuritional Risk in Emergency (NRE)‐2017 to the other tools.
Results
A total of 748 patients were included. The final NRE‐2017 score was composed of 6 questions (advanced age, metabolic stress of the disease, decreased appetite, changing of food consistency, unintentional weight loss, and muscle mass loss) with answers yes or no. The prevalence of nutrition risk was 50.7% and 38.8% considering the cutoff points 1.0 and 1.5, respectively. The NRE‐2017 showed a satisfactory power to indentify risk of malnutrition (area under the curve >0.790 for all analyses). According to the NRE‐2017, patients at risk of malnutrition have twice as high relative risk of a very long hospital stay. The hazard ratio for mortality was 2.78 (1.03–7.49) when the cutoff adopted by the NRE‐2017 was 1.5 points.
Conclusion
NRE‐2017 is a new, easy‐to‐apply nutrition screening tool which uses 6 bi‐categoric features to detect the risk of malnutrition, and it presented a good concurrent and predictive validity.