Malnutrition screening on hospital admission: impact of overweight and obesity on comparative performance of MUST and PG-SGA SF
Open Access
- 15 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Nutrition
- Vol. 75 (9), 1398-1406
- https://doi.org/10.1038/s41430-020-00848-4
Abstract
Background/objectives Traditional malnutrition screening instruments, including the Malnutrition Universal Screening Tool (MUST), strongly rely on low body mass index (BMI) and weight loss. In overweight/obese patients, this may result in underdetection of malnutrition risk. Alternative instruments, like the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), include characteristics and risk factors irrespective of BMI. Therefore, we aimed to compare performance of MUST and PG-SGA SF in malnutrition risk evaluation in overweight/obese hospitalized patients. Subjects/methods We assessed malnutrition risk using MUST (≥1 = increased risk) and PG-SGA SF (≥4 = increased risk) in adult patients at hospital admission in a university hospital. We compared results for patients with BMI < 25 kg/m2 vs. BMI ≥ 25 kg/m2. Results Of 430 patients analyzed (58 ± 16 years, 53% male, BMI 26.9 ± 5.5 kg/m2), 35% were overweight and 25% obese. Malnutrition risk was present in 16% according to MUST and 42% according to PG-SGA SF. In patients with BMI < 25 kg/m2, MUST identified 31% as at risk vs. 52% by PG-SGA SF. In patients with BMI ≥ 25 kg/m2, MUST identified 5% as at risk vs. 36% by PG-SGA SF. Agreement between MUST and PG-SGA SF was low (к = 0.143). Of the overweight/obese patients at risk according to PG-SGA SF, 83/92 (90%) were categorized as low risk by MUST. Conclusions More than one-third of overweight/obese patients is at risk for malnutrition at hospital admission according to PG-SGA SF. Most of them are not identified by MUST. Awareness of BMI-dependency of malnutrition screening instruments and potential underestimation of malnutrition risk in overweight/obese patients by using these instruments is warranted.Keywords
This publication has 57 references indexed in Scilit:
- Malnutrition risk in newly hospitalized overweight and obese individuals: Mr NOIEuropean Journal of Clinical Nutrition, 2013
- Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare SystemInternational Journal of Environmental Research and Public Health, 2011
- Nutrition impact symptoms: Key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatmentHead & Neck, 2009
- Prognostic impact of disease-related malnutritionClinical Nutrition, 2008
- Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation toolsEuropean Journal of Clinical Nutrition, 2007
- Comparison of tools for nutritional assessment and screening at hospital admission: A population studyClinical Nutrition, 2006
- Prenatal programming of postnatal obesity: fetal nutrition and the regulation of leptin synthesis and secretion before birthProceedings of the Nutrition Society, 2004
- Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancerEuropean Journal of Clinical Nutrition, 2002
- Definition of standardized nutritional assessment and interventional pathways in oncologyNutrition, 1996