Background: Identification of patients at risk for malnutrition is important for timely nutrition intervention to reduce morbidity and mortality. Objective: The objective of this study was to compare the sensitivity and specificity of the Nutrition Risk Screen (NRS) 2002 and the ThedaCare NRS to identify patients at risk for malnutrition. Methods: The NRS 2002 and ThedaCare NRS were administered to 594 patients, aged 63 ± 16 years (mean ± SD), in the non–intensive care unit hospital setting. Risk for malnutrition and malnutrition diagnosis were confirmed with the 6 malnutrition clinical characteristics defined by the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition and using the nutrition assessment that included the Nutrition Focused Physical Exam. Sensitivity, specificity, and κ coefficient were calculated. Results: When compared with the NRS 2002, the ThedaCare NRS had higher sensitivity (98.8% vs 63.5%), indicating improved identification of patients at risk for malnutrition, but lower specificity (74.0% vs 93.4%), indicating that more patients at low risk for malnutrition were misclassified. ThedaCare NRS missed fewer patients at risk for malnutrition when compared with the NRS 2002. ThedaCare NRS had a higher κ coefficient when compared with the NRS 2002, indicating better agreement of results regardless of who administered the screen. The ThedaCare NRS required less time to complete when compared with the NRS 2002 (mean ± SE: ThedaCare, 17 ± 1 seconds; NRS 2002, 9 ± 1 minutes; P <.0001). Conclusion: The ThedaCare NRS improves the identification of patients at risk for malnutrition in the non–intensive care unit hospital setting. This trial was registered at www.clinicaltrials.gov as NCT02585245.
Bibliographical noteFunding Information:
The authors would like to acknowledge Angelica Gronke for her efforts in the development and conduction of the competencies and training for the Nutrition Focused Physical Exam necessary to instruct the registered dietitian nutritionists collecting the data for this study. The authors would like to thank the Sharon Weitz, the registered dietitian nutritionists and nutrition and dietetics technicians, registered, at the ThedaCare Regional Hospitals, Appleton and Neenah, Wisconsin, for their contributions in the data collection for this study. L. L. K. Hartz, B. M. Stroup, C. Shockey, and D. M. Ney contributed to the conception and design of the research. L. L. K. Hartz, B. M. Stroup, T. A. Bibelnieks, and C. Shockey contributed to analysis of the data. B. M. Stroup and T. A. Bibelnieks contributed to analysis and interpretation of the data. L. L. K. Hartz, B. M. Stroup, T. A. Bibelnieks, C. Shockey, and D. M. Ney drafted the manuscript. All authors critically revised the manuscript, agree to be accountable for the accuracy and integrity of the data, and read and approved the final version of this manuscript.
- Nutrition Focused Physical Assessment
- Nutrition Focused Physical Exam
- length of hospital stay