Comparison of Tools for Nutrition Assessment and Screening for Predicting the Development of Complications in Orthopedic Surgery
- 1 April 2009
- journal article
- research article
- Published by Wiley in Nutrition in Clinical Practice
- Vol. 24 (2), 274-280
- https://doi.org/10.1177/0884533609332087
Abstract
Background: Malnutrition in hospitalized patients is a significant problem. The purpose of this study was to compare 2 assessment tools—the Nutritional Risk Screening 2002 (NRS 2002) and subjective global assessment (SGA)—in predicting development of complications in patients undergoing orthopedic surgery. Methods: Nutrition status was assessed by the SGA, and nutrition screening was performed using the NRS 2002 in 256 consecutively admitted patients scheduled for orthopedic surgery. Additional information recorded for all patients included age, gender, body mass index, and American Society of Anesthesiologists (ASA) physical status. Patient outcomes (postoperative complications), mortality rate, and length of hospital stay (LOS) were investigated. Results: Malnourished or nutritionally at-risk patients were significantly older than nonmalnourished or not at-risk patients according to the SGA and NRS 2002. Also, ASA physical status was correlated with malnutrition or malnutrition risk. Malnourished and at-risk patients in both the SGA and NRS 2002 groups showed longer LOS and higher morbidity and mortality rates. Sensitivity was 50% with the SGA and 69% with the NRS 2002; specificity was 77% with the SGA and 80% with the NRS 2002. Agreement between 2 methods was 0.672. The odds ratio for the association between malnutrition or risk of malnutrition and the occurrence of complications was 3.5 (1.7-7.1) for the SGA and 4.1 (2.0-8.5) for NRS 2002. Conclusions: Age and ASA physical status are risk factors for malnutrition. In patients undergoing orthopedic surgery, NRS 2002 predicted development of complications better than the SGA. Malnutrition also increased length of hospital stay.Keywords
This publication has 27 references indexed in Scilit:
- Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgeryClinical Nutrition, 2008
- ESPEN Guidelines for Nutrition Screening 2002Clinical Nutrition, 2003
- Assessment of nutritional status on hospital admission: nutritional scoresEuropean Journal of Clinical Nutrition, 2003
- Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal careEuropean Journal of Clinical Nutrition, 2002
- Hospital-associated malnutrition: A reevaluation 12 years laterJournal of the American Dietetic Association, 1993
- Effect of Admission Nutritional Status on Length of Hospital StayGastroenterology Nursing, 1991
- Assessment of Nutritional StatusJournal of Parenteral and Enteral Nutrition, 1990
- Prevention of Complications in Orthopedic Surgery Secondary to Nutritional DepletionClinical Orthopaedics and Related Research, 1987
- Nutritional AssessmentNew England Journal of Medicine, 1982
- Nutritional Status of Orthopedic Patients with Surgical ComplicationsClinical Orthopaedics and Related Research, 1981