Simplified malnutrition tool for Thai patients

Abstract

Malnutrition in hospitals often goes unrecognized. At present, no nutrition screening tool provides satisfactory re-sults in identifying nutritional risk. Most tools depend on weight and height as criteria for diagnosing malnutrition. Weight is not recorded in many patients and some tools are time-consuming. An inclusive nutrition screening form (Nutrition Alert Form, NAF) was developed and validated. NAF was modified from the original version of Subjective Global Assessment (SGA) by adding in two standard laboratory tests. The severity of the symptom and laboratory changes were scored. NAF was validated in 210 hospitalized Thai patients at Ramathibodi hospital by an experienced clinical nutritionist (physician) at Ramathibodi hospital. Cross validation was carried out between the dietitian and nurse in another 90 patients. Most of the time nurses could complete the nutrition screening in a patient within 5 minutes. One out of four patients could not be weighed on admission. The scores of 5 and 11 were selected as the cut-off scores of different malnutrition levels due to their high sensitivity, specificity and accuracy and scores of 6 to 10 were defined as moderate malnutrition. The diagnostic agreement between the dietitian and nurse for "normal to mild malnutrition", "moderate malnutrition", and "severe malnutrition" were 85%, 70% and 72%, respectively. NAF for screening of malnutrition in hospitalized Thai patients is easy to use, concise, does not require nutrition expertise and can be used whether or not body weight is taken.