Elmore et al developed a subjective screening tool to evaluate hospitalized adults for nutritional risk. A patient at risk should be referred to a dietitian for evaluation. The authors are from Indianapolis, Indiana.
NOTE: The Nutrition Screening Equation (NSEq) is discussed below with the Indices for Nutritional Assessment.
Parameters:
(1) history of recent hospitalization
(2) nursing home residence
(3) age
(4) recent weight loss
(5) problems prior to admission
(6) admission diagnoses
(7) other existing conditions
(8) serum albumin
|
Parameter |
Finding |
Points |
|
recent hospitalization |
within past 2 months |
1 |
|
|
not within past 2 months |
0 |
|
nursing home resident |
yes |
1 |
|
|
no |
0 |
|
age |
>= 65 years of age |
1 |
|
|
< 65 years |
0 |
|
weight change |
unintentional weight loss >= 10% of usual weight in past 6 months, OR >= 5% within past 4 weeks |
4 |
|
|
neither |
0 |
|
serum albumin |
< 3.5 g/dL |
6 |
|
|
>= 3.5 g/dL |
0 |
|
Parameters Prior to Admission |
Finding |
Points |
|
daily vomiting prior to admission |
yes |
2 |
|
|
no |
0 |
|
daily diarrhea prior to admission |
yes |
2 |
|
|
no |
0 |
|
poor appetite prior to admission |
yes |
2 |
|
|
no |
0 |
|
trouble chewing or swallowing prior to admission |
yes |
1 |
|
|
no |
0 |
|
major surgery prior to admission |
recent history |
1 |
|
|
no recent history |
0 |
|
Diagnosis |
Condition |
Points |
|
admission |
celiac disease, congestive heart failure, abdominal pain, diabetes out of control, esophageal stricture, gangrene, hyperemesis gravidarum, rule out cancer, enlarged lymph nodes, anemia, masses or lumps, intestinal obstruction, blood disorder, pyrexia of unknown origin (FUO), decubitus ulcer, septicemia, multiple sclerosis, cerebral palsy |
1 point for each |
|
|
alcoholism, anorexia nervosa, cancer, cirrhosis, Crohn's disease, cystic fibrosis, GI hemorrhage, hepatic disease or fibrosis, inflammatory bowel disease, malabsorption, multiple fractures, renal disease, renal disease, ulcerative colitis, weight loss, cell immune deficiency |
3 points for each |
|
|
major burns, malnutrition, multiple trauma |
6 points for each |
|
other existing conditions |
any not listed as an admission diagnosis |
1 point for each |
total risk score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 0
• maximum score: > 30 (depending on the number of diagnoses)
• A person with a score >= 6 should be considered to be at risk for nutritional risk and referred for evaluation by a registered dietitian.
NOTE: I think most adults admitted to a hospital would meet the criteria for evaluation.
Specialty: Nutrition
ICD-10: ,
