Development, validation and implementation of a program to detect malnutrition with NRS-2002 screening tool in patients from the oncology and hematology service
DOI:
https://doi.org/10.12873/411sorianoPalavras-chave:
Nutritional screening, hospital malnutrition, disease-related malnutrition, oncologyResumo
Introduction: Hospital malnutrition (HM) is an increasingly prevalent situation, which involves both an increase in health costs, and also a decrease in the life quality and greater morbimortality. Nutritional screening is essential to detect malnutrition early and avoid these complications.
Objectives: To develop, validate and implement the Nutritional Risk Screening 2002 (NRS-2002) tool at the admission and during the hospitalization of a patient in the oncohematology service in a third level hospital, and know their nutritional status at the admission and the discharge.
Methods: NRS-2002 was performed on all patients admitted to the oncohaematology service, followed by the complete nutritional assessment (NA) to check its validity. NRS-2002 is repeated weekly to determine the degree of malnutrition during the hospital stay.
Results: 573 patients were admitted to the oncohematology service, of which a 34.4% suffered from malnutrition, 44.7% had risk of malnutrition and 20.9% were in good nutritional condition, at the time they were admitted to hospital according to the NRS-2002. In patients admitted for more than a week, NRS-2002 was performed weekly and found that, upon discharge, a 34.4% were malnourished, 50.8% had a risk of malnutrition and the last 14.76% were in good nutritional status; also a 12.3% worsened their nutritional status, the 68.9% maintained it and only a 18.9% improved it. 78.8% of patients with longer admissions require a NA.
Discussion: Due to the high risk of malnutrition in hospital admission, the use of nutritional screening is necessary, both at admission and during hospital stay to avoid nutritional deterioration during the same.
Conclusions: Our results suggest that the NRS-2002 is a simple and effective method for early malnutrition detection.
Referências
Lobo G, Ruiz MD & Pérez AJ. Desnutrición hospitalaria: relación con la estancia media y la tasa de reingresos prematuros. Med Clin. 2009;132(10):377-384.
Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36:49-64.
Buijs N, Van Bokhorst M, Langius J, Leemans C, Kuik D, Vermeulen M, et al. Perioperative arginine-supplemented nutrition in malnourished patients with head and neck cancer improves long-term survival. Am J Clin Nutr. 2010;92(5):1151-1156.
Palma S, Meneses D, Valero M, Calso M, García N, Ruiz M, et al. Costes asociados a la desnutrición relacionada con la enfermedad y su tratamiento: revisión de la literatura. Nutr. Hosp. 2018;35:442-460.
Álvarez J, Planas M, León M, García A, Celaya S, García P, et al. Prevalence and costs of malnutrition in hospitalized patients; The PREDyCES® Study. Nutr Hosp. 2012;27(4):1049-1059.
ENHA. 3ª conferencia de la Optimal Nutrional Care For All. Alianza masnutridos 2016. [Consultado: 25 de noviembre de 2020]. Disponible en: http://www.alianzamasnutridos.es/news/1,7%20millones%20de%20adultos%20en%20Espa%C3%B1a,%20en%20riesgo%20de%20desnutrici%C3%B3n/
Cederholm T, Jensen GL, Correia M, Gonzalez M, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9.
Álvarez J, Del rio J, Planas M, García P, García A, Calvo V, et al. Documento SENPE-SEDOM sobre la codificación de la desnutrición hospitalaria. Nutr. Hosp. 2008;23(6):536-540.
Jensen G, Compher C, Sullivan D & Mullin G. Recognizing Malnutrition in Adults: definitions and Characteristics, Screening, Assessment and Team Approach. J Parenter Enteral Nutr. 2013;37(6):802-807.
SENPE. Consenso Multidisciplinar sobre el abordaje de la desnutrición hospitalaria en España. Promovido por la Sociedad Española de Nutrición Parenteral y Enteral (SENPE). 2011. Barcelona: Editorial Glosa, S.L.
Waitzberg D, Ravacci G & Raslan M. Hospital hyponutrition. Nutr. Hosp. 2011;26(2):1-36.
de Ulibarri JI, Picón MJ, García E & Mancha A. Early detection and control of hospital malnutrition. Nutr Hosp. 2002:17(3):139-146.
Glosario de términos en desnutrición clínica. [Consultado: 2 de febrero del 2020]. Disponible: https://controlnutricional.files.wordpress.com/2010/12/glosario-de-terminos-en-desnutricion-clinica.pdf
de Ulibarri JI. Cribado nutricional y eficiencia. Nutr. Hosp. 2018;35(4):1001-1002.
Vazeille C, Jouinot A, Durand JP, Neveux N, Boudou P, Huillard O, et al. Relation between hypermetabolism, cachexia, and survival in cancer patients: a prospective study in 390 cancer patients before initiation of anticancer therapy. Am J Clin Nutr 2017;105(5):1139-1147.
Kondrup J, Rasmussen H y Hamberg O & Stanga Z. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-336.
Stewart A, Marfell M, Olds T & Ridder H. Prtocolo internacional para la valoración antropométrica. Sociedad internacional para el avance de la Cineantropometría (ISAK). Portsmouth: ISAK. 2011.
Gutiérrez JL, Aguilar S, Casas M, Garza I, Ortega V & Martinez M. Screening of nutritional risk: assessment of predictive variables of nutritional risk in hospitalized patients in a second-level care center in Mexico. Nutr Hosp. 2019;36(3):626-632.
Barbosa AAO, Pereira A & Ramos F. Comparação dos critérios da nrs-2002 com o risco nutricional em pacientes hospitalizados. Ciênc. Saúde Colet. 2019;24:3325-3334.
Burgos R, Joaquin C, Blay C & Vaqué C. Disease-related malnutrition in hospitalized chronic patients with complex needs. Clin Nutr. 2020;39(5):1447-1453.
Lin Y, Wang M, Sun N, Liu Y, Yin T & Chen C. Screening and application of nutritional support in elderly hospitalized patients of a tertiary care hospital in China. PLoS One. 2019;14(3):213.276.
Álvarez K, Delgadillo T, García A, Alatriste G & Vanessa F. Prevalence of nutritional risk evaluated with NRS-2002 in Mexican oncology population. Nutr. Hosp. 2014;30(1):173-178.
Müller M, Dahal S, Saffarini M, Uehlinger D & Arampatzis S. Evaluation of Nutrition Risk Screening Score 2002 (NRS) assessment in hospitalized chronic kidney disease patient. PLoS One. 2019;14(1):200-211.
García P, Velasco C, Frias L, Higuera I, Bretón I, Clambor M, et al. Protocol for the implementation of a screening tool for the early detection of nutritional risk in a university hospital. Endocrinol Diabetes Nutr. 2019;66(9):555-562.
Stollhof L, Braun J, Ihle C, Schreiner J, Kufeldt J, Adolph M, et al. The continuous downgrading of malnutrition in the German DRG system: possible effects on the treatment of patients at risk for malnutrition. EXCLI Journal. 2019;18:370-381.
Li Y, Nie R, Wu T, Li S, Chen S, Whang W, et al. Prognostic Value of the Nutritional Risk Screening 2002 Scale in Metastatic Gastric Cancer: A Large-Scale Cohort Study. Journal of Cancer. 2019;10(1):112-119.
Chivu EC, Artero A, García A & Sánchez C Detection of malnutrition risk in hospital. Nutr Hosp 2016;33(4):894-900.
Moriana M, Civera M, Artero A, Real J, Caro J, Acaso F, et al. Validity of subjective global assessment as a screening method for hospital malnutrition. Prevalence of malnutrition in a tertiary hospital. Endocrinol Nutr. 2014;61(4):184-189
Sremanakova J, Burden S, Kama Y, Gittins M, Lal S, Smith C, et al. An observational cohort study investigating risk of malnutrition using the malnutrition universal screening tool in patients with stroke. J Stroke Cerebrovasc Dis. 2019;28(12):104-405.
Vieira Teles M, Leandro Merhi VA, Braga de Aquino JL, Teixeira Mendes E D, Mendonça JA. Do more overweight patients at admission lose weight during hospitalization?. Nutr. Clin. y Diet. Hosp. 2020;40(3):176-179.
Downloads
Publicado
Como Citar
Licença
Copyright (c) 2021 Nutrición Clínica y Dietética Hospitalaria
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)
