Lim et al developed a simple nutrition screening tool for patients being admitted to the hospital. The nutritional assessment can be completed within 3 minutes. The authors are from National University Hospital, Princess Alexandra Hospital, National Healthcare Group, Singapore Clinical Research Institute and Queensland University of Technology (Australia).
Patient selection: acute hospital admission
Parameters:
(1) unintentional weight loss in past 6 months
(2) nutritional intake in past week
(3) muscle wasting over temple (temporalis muscle) or clavicle
Parameter
Finding
Points
unintentional weight loss
intentional weight loss
0
weight gain
0
unchanged
0
don’t know
1
weight loss but unsure amount
2
< 1 kg
0
1 to 3 kg
1
3.1 to 7 kg
2
> 7 kg
3
nutritional intake
oral, less than 25% of normal meal
3
oral, 25 to 49% of usal meal without oral supplement
2
oral, 25 to 49% of usual meal with oral supplement
1
oral, 50-74% of usual meal
1
oral, >= 75% of usual meal
0
tube feeding, > 1,500 kcal per day
0
tube feeding, 1250 to 1500 kcal per day
1
tube feeding, 1000 to 1239 kcal per day
2
tube feeding, < 1,000 kcal per day
3
muscle wastage
hollowing or depression of temporalis, protruding clavicle bone
3
slight depression or protrusion
2
absent (well-defined temporalis muscle, no protrusion of clavicle bone)
0
total score =
= SUM(points for 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• A score >= 5 indicates severe malnutrition.
• A score of 3 or 4 indicates risk of moderate malnutrition.
Performance:
• For a cutoff of >= 3 to indicate risk of malnutrition, the sensitivity was 86% and specificity 83%.
• For detection of severe malnutrition the sensitivity was 93% and specificity 86%.
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