The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture
Background The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropom...
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| Veröffentlicht in: | Journal of human nutrition and dietetics 2013-12, Vol.26 (6), p.519-526 |
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| creator | Bell, J. J. Bauer, J. D. Capra, S. |
| description | Background
The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit.
Methods
Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) |
| doi_str_mv | 10.1111/jhn.12040 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1459563823</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3128899431</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4920-6bbcf4afb57f94ae79efbddd55c66c485c9b02d320b0f82c4d15d2804673df713</originalsourceid><addsrcrecordid>eNp10E1PFTEUBuCGaOAKLPwDpokbXQz0cz6WhgiofCRyDe5qpz3l9jIzvbQzKP_eygVCTOimSfOcNz0vQm8p2aP57C8Xwx5lRJANNKO8lAWrqp-v0Iw0khW8rugWepPSkhBSUkI20Rbjdd0QwWbo13wB-FR3wzRGP_ow4AsTAQY_XOF5CB2-hZimhEO7BDP6W8A96DRFSHgM2MKYX3H_fN4PeOFX2EVtxux20GunuwS7D_c2-nH4eX5wXJycH305-HRSGNEwUpRta5zQrpWVa4SGqgHXWmulNGVpRC1N0xJmOSMtcTUzwlJpWU1EWXHrKsq30Yd17iqGmwnSqHqfDHSdHiBMSVEhG1nymvFM3_9Hl2GKQ_7dvaIlozXJ6uNamRhSiuDUKvpexztFifpXu8q1q_vas333kDi1Pdgn-dhzBvtr8Nt3cPdykvp6fPYYWawnfBrhz9OEjtcqr1xJdXl2pPj3b-yCcqFO-V-HW5ve</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1459162180</pqid></control><display><type>article</type><title>The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Bell, J. J. ; Bauer, J. D. ; Capra, S.</creator><creatorcontrib>Bell, J. J. ; Bauer, J. D. ; Capra, S.</creatorcontrib><description>Background
The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit.
Methods
Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) < 22 kg m–2, or MUAC < 25 cm] was compared with malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10‐Australian Modification (ICD10‐AM) coding criteria.
Results
Malnutrition prevalence was 37.5% using ICD10‐AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28).
Conclusions
In this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under‐diagnosis and treatment of malnutrition, leading to case‐mix funding losses.</description><identifier>ISSN: 0952-3871</identifier><identifier>EISSN: 1365-277X</identifier><identifier>DOI: 10.1111/jhn.12040</identifier><identifier>PMID: 23889042</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Australia - epidemiology ; Body Mass Index ; Cognition Disorders - diagnosis ; Cognition Disorders - physiopathology ; Dementia - diagnosis ; Dementia - physiopathology ; elderly ; Female ; Fractures ; hip fracture ; Hip Fractures - physiopathology ; Hip joint ; Humans ; Length of Stay ; Male ; Malnutrition ; Malnutrition - diagnosis ; Malnutrition - epidemiology ; Mass Screening ; Medical Audit ; Medical screening ; Nutrition Assessment ; nutrition screening ; Nutritional Status ; Older people ; Prevalence ; Prospective Studies ; Risk Factors ; Sensitivity and Specificity</subject><ispartof>Journal of human nutrition and dietetics, 2013-12, Vol.26 (6), p.519-526</ispartof><rights>2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.</rights><rights>Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4920-6bbcf4afb57f94ae79efbddd55c66c485c9b02d320b0f82c4d15d2804673df713</citedby><cites>FETCH-LOGICAL-c4920-6bbcf4afb57f94ae79efbddd55c66c485c9b02d320b0f82c4d15d2804673df713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjhn.12040$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjhn.12040$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23889042$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bell, J. J.</creatorcontrib><creatorcontrib>Bauer, J. D.</creatorcontrib><creatorcontrib>Capra, S.</creatorcontrib><title>The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture</title><title>Journal of human nutrition and dietetics</title><addtitle>J Hum Nutr Diet</addtitle><description>Background
The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit.
Methods
Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) < 22 kg m–2, or MUAC < 25 cm] was compared with malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10‐Australian Modification (ICD10‐AM) coding criteria.
Results
Malnutrition prevalence was 37.5% using ICD10‐AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28).
Conclusions
In this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under‐diagnosis and treatment of malnutrition, leading to case‐mix funding losses.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Australia - epidemiology</subject><subject>Body Mass Index</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - physiopathology</subject><subject>Dementia - diagnosis</subject><subject>Dementia - physiopathology</subject><subject>elderly</subject><subject>Female</subject><subject>Fractures</subject><subject>hip fracture</subject><subject>Hip Fractures - physiopathology</subject><subject>Hip joint</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Malnutrition - diagnosis</subject><subject>Malnutrition - epidemiology</subject><subject>Mass Screening</subject><subject>Medical Audit</subject><subject>Medical screening</subject><subject>Nutrition Assessment</subject><subject>nutrition screening</subject><subject>Nutritional Status</subject><subject>Older people</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><issn>0952-3871</issn><issn>1365-277X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10E1PFTEUBuCGaOAKLPwDpokbXQz0cz6WhgiofCRyDe5qpz3l9jIzvbQzKP_eygVCTOimSfOcNz0vQm8p2aP57C8Xwx5lRJANNKO8lAWrqp-v0Iw0khW8rugWepPSkhBSUkI20Rbjdd0QwWbo13wB-FR3wzRGP_ow4AsTAQY_XOF5CB2-hZimhEO7BDP6W8A96DRFSHgM2MKYX3H_fN4PeOFX2EVtxux20GunuwS7D_c2-nH4eX5wXJycH305-HRSGNEwUpRta5zQrpWVa4SGqgHXWmulNGVpRC1N0xJmOSMtcTUzwlJpWU1EWXHrKsq30Yd17iqGmwnSqHqfDHSdHiBMSVEhG1nymvFM3_9Hl2GKQ_7dvaIlozXJ6uNamRhSiuDUKvpexztFifpXu8q1q_vas333kDi1Pdgn-dhzBvtr8Nt3cPdykvp6fPYYWawnfBrhz9OEjtcqr1xJdXl2pPj3b-yCcqFO-V-HW5ve</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Bell, J. J.</creator><creator>Bauer, J. D.</creator><creator>Capra, S.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201312</creationdate><title>The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture</title><author>Bell, J. J. ; Bauer, J. D. ; Capra, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4920-6bbcf4afb57f94ae79efbddd55c66c485c9b02d320b0f82c4d15d2804673df713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Australia - epidemiology</topic><topic>Body Mass Index</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - physiopathology</topic><topic>Dementia - diagnosis</topic><topic>Dementia - physiopathology</topic><topic>elderly</topic><topic>Female</topic><topic>Fractures</topic><topic>hip fracture</topic><topic>Hip Fractures - physiopathology</topic><topic>Hip joint</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Malnutrition - diagnosis</topic><topic>Malnutrition - epidemiology</topic><topic>Mass Screening</topic><topic>Medical Audit</topic><topic>Medical screening</topic><topic>Nutrition Assessment</topic><topic>nutrition screening</topic><topic>Nutritional Status</topic><topic>Older people</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bell, J. J.</creatorcontrib><creatorcontrib>Bauer, J. D.</creatorcontrib><creatorcontrib>Capra, S.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of human nutrition and dietetics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bell, J. J.</au><au>Bauer, J. D.</au><au>Capra, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture</atitle><jtitle>Journal of human nutrition and dietetics</jtitle><addtitle>J Hum Nutr Diet</addtitle><date>2013-12</date><risdate>2013</risdate><volume>26</volume><issue>6</issue><spage>519</spage><epage>526</epage><pages>519-526</pages><issn>0952-3871</issn><eissn>1365-277X</eissn><abstract>Background
The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under‐diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit.
Methods
Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) < 22 kg m–2, or MUAC < 25 cm] was compared with malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10‐Australian Modification (ICD10‐AM) coding criteria.
Results
Malnutrition prevalence was 37.5% using ICD10‐AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28).
Conclusions
In this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under‐diagnosis and treatment of malnutrition, leading to case‐mix funding losses.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23889042</pmid><doi>10.1111/jhn.12040</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Australia - epidemiology Body Mass Index Cognition Disorders - diagnosis Cognition Disorders - physiopathology Dementia - diagnosis Dementia - physiopathology elderly Female Fractures hip fracture Hip Fractures - physiopathology Hip joint Humans Length of Stay Male Malnutrition Malnutrition - diagnosis Malnutrition - epidemiology Mass Screening Medical Audit Medical screening Nutrition Assessment nutrition screening Nutritional Status Older people Prevalence Prospective Studies Risk Factors Sensitivity and Specificity |
| title | The Malnutrition Screening Tool versus objective measures to detect malnutrition in hip fracture |
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