The Nutrition Risk Score can be used to screen hospitalized patients for risk of nutritional problems. It is simple to use and can be applied to all patient categories. It was developed by Reilly et al at the Birmingham Heartlands Hospital in Birmingham UK.
Measures:
(1) body weight
(2) body mass index (BMI)
(3) appetite
(4) ability to eat and/or retain food
(5) stress factor
|
Step |
Parameter |
Finding |
Points |
|
1 |
pediatric (0-17 years) |
present weight expected weight for length |
0 |
|
|
|
present weight 90-99% of expected weight for length |
2 |
|
|
|
present weight 80-89% of expected weight for length |
4 |
|
|
|
present weight <= 79% of expected weight for length |
6 |
|
|
adult (>= 18 years) |
no unintentional weight loss in last 3 months |
0 |
|
|
|
unintentional weight loss 0-3 kg in last 3 months |
1 |
|
|
|
unintentional weight loss 3.1 – 5.9 kg in last 3 months |
2 |
|
|
|
unintentional weight loss >= 6 kg in last 3 months |
3 |
|
2 |
pediatric (0-17 years) |
|
0 |
|
|
adult (>= 18 years) |
BMI >= 20 |
0 |
|
|
|
BMI 18 or 19 |
1 |
|
|
|
BMI 15-17 |
2 |
|
|
|
BMI < 15 |
3 |
|
3 |
appetite |
good appetite, manages most of 3 meals a day (or equivalent) |
0 |
|
|
|
poor appetite with poor intake; leaves more than half of meals provided (or equivalent) |
2 |
|
|
|
appetite nil or virtually nil, unable to eat, nothing by mouth for > 4 meals |
3 |
|
4 |
ability to eat and/or retain food |
no difficulty eating, able to eat independently, no diarrhea or vomiting |
0 |
|
|
|
problems handling food (special cutlery needed, etc.); mild vomiting or frequent regurgitation (or possetting); mild diarrhea |
1 |
|
|
|
difficulty swallowing (requires modified consistency); problems with dentures, affecting food intake; problems with chewing, affecting food intake; slow to feed; moderate vomiting and/or diarrhea (1-2 times per day in children); needs help with feeding |
2 |
|
|
|
unable to take food orally; unable to swallow (complete dysphagia); severe vomiting and/or diarrhea (> 2 times per day in children); malabsorption |
3 |
|
5 |
stress factor |
no stress factor |
0 |
|
|
|
mild (minor surgery, minor infection) |
1 |
|
|
|
moderate (chronic disease, major surgery, infection, fracture, pressure sore or ulcer, CVA, inflammatory bowel disease, other gastrointestinal disorders |
2 |
|
|
|
multiple injuries, multiple fractures, multiple burns, multiple deep pressure sores or ulcers, severe sepsis, carcinoma or other malignant disease |
3 |
from Figure page 271
where:
• The original table gives a weight loss of adults as "> 3 – 6 kg" and "6 kg or more", which overlap at 6 kg.
• body mass index = (body weight in kilograms) / ((height in meters)^2)
nutrition risk score =
= SUM(points for all 5 steps)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score, the greater the nutritional risk.
• I could not find a mapping from nutrition risk score to severity. A possible scheme might be: > 12 severe, 7 –12 moderate, 1-6 mild, 0 none.
Specialty: Nutrition
ICD-10: ,
