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Πέμπτη 5 Μαΐου 2022

Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study

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Abstract

Background

Disease-related-malnutrition predicts poor clinical outcomes in elderly patients, and screening is pivotal to identify patients at nutritional risk. This study aimed to investigate nutrition screening rates in electronic patient records, and validate the scores given. Secondary was to investigate whether the proportion of patients at risk differed between patients where screening was documented and those where no screening was documented.

Methods

This cross-sectional observational study was conducted in a Danish university hospital during November 2020. Patients aged 65 years or more admitted to a medical department were included. The Nutrition Risk Screening (NRS-2002) tool was used to identify patients at nutritional risk, both in routine clinical care, where data were collected retrospectively, and during a validation process in a random patient sample, where data were collected prospectively.

Results

In total, 817 patients were ad mitted for more than 24 hours. Of these, an NRS-2002 score was documented in 294 (36%), among whom 177 (60%) were at nutritional risk. In 146 patients where no score was documented, 88 (60%) were at risk. Validation was possible in 91 patients where a record-based score and a validated score were documented. The specificity of the record-based score was 100%, while the sensitivity was 75%, indicating that routine screening underestimated nutritional risk (p<0.001, proportion difference 19%(95%CI 10;28%)).

Conclusions:

Electronic documentation does not solve issues about compliance with nutritional risk screening. In patients where screening was not documented, the occurrence of nutritional risk was similar, indicating that omission of screening is not related to the score.

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