Abstract
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.