Evaluation of Nutritional Status in Hospitalized Patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Bo , WU Xiaoting.

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

Keywords：

Malnutrition; Nutritional risk; Nutritional risk screening 2002; Nutritional support; Hospitalized patient

Video：

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ObjectiveTo introduce the progresses and applications of nutritional status assessment in hospitalized patients. MethodsThe related literatures of nutritional status assessment were reviewed. ResultsThe rates of malnutrition and nutritional risk were high in hospitalized patients worldwide. Traditional nutrition assessment tools were not in common use in all hospitalized patients. All clinical health care workers should use the most suitable tool when faced with different patients. ConclusionAll hospitalized patients should be screened for nutritional risk on admission in order to improve clinical outcomes and reduce overall treatment costs.

Citation： CHEN Bo,WU Xiaoting.. Evaluation of Nutritional Status in Hospitalized Patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(4): 449-454. doi: Copy

1.	Kondrup J, Rasmussen HH, Hamberg O, et al; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials [J]. Clin Nutr, 2003, 22(3): 321336．.
2.	Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics [J]. Clin Nutr, 2006, 25(2): 180186.
3.	王艳, 蒋朱明, Nolan MT, 等. 营养风险的概念分析 [J]. 中华临床营养杂志, 2009, 17(2): 104106.
4.	Johansen N, Kondrup J, Plum LM, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk [J]. Clin Nutr, 2004, 23(4): 539550.
5.	中华医学会. 临床技术操作规范－肠外肠内营养学分册 [M]. 北京: 人民军医出版社, 2008: 159.
6.	Green SM, Watson R. Nutritional screening and assessment tools for use by nurses: literature review [J]. J Adv Nurs, 2005, 50(1): 6983.
7.	Bistrian BR, Blackburn GL, Vitale J, et al. Prevalence of malnutrition in general medical patients [J]. JAMA, 1976, 235(15): 15671570.
8.	Blackburn GL, Bistrian BR, Maini BS, et al. Nutritional and metabolic assessment of the hospitalized patient [J]. JPEN J Parenter Enteral Nutr, 1977, 1(1): 1122.
9.	McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital [J]. BMJ, 1994, 308(6934): 945948.
10.	Fettes SB, Davidson HI, Richardson RA, et al. Nutritional status of elective gastrointestinal surgery patients pre and postoperatively [J]. Clin Nutr, 2002, 21(3): 249254.
11.	蒋朱明，陈伟，张澍田．中国11个城市大医院6个临床专科5 303例住院患者营养不良风险筛查(期中小结摘要) [J]. 中国临床营养杂志, 2006, 14(4): 263.
12.	蒋朱明，陈伟，朱赛楠，等．我国东、中、西部大城市三甲医院营养不良（不足）、营养风险发生率及营养支持应用状况调查 [J]. 中国临床营养杂志, 2008, 16(6): 335337.
13.	蒋朱明，于康，朱赛楠，等．我国东、中、西部中小医院住院患者营养不良（不足）、营养风险、超重和肥胖发生率及营养支持应用状况调查（中期小结） [J]. 中国临床营养杂志, 2008, 16(6): 338340.
14.	Oliveira MR, Fogaa KC, LeandroMerhi VA. Nutritional status and functional capacity of hospitalized elderly [J]. Nutr J, 2009, 8: 54.
15.	Liang X, Jiang ZM, Nolan MT, et al. Comparative survey on nutritional risk and nutritional support between Beijing and Baltimore teaching hospitals [J]. Nutrition, 2008, 24(10): 969976.
16.	Mackintosh MA, Hankey CR. Reliability of a nutrition screening tool for use in elderly day hospitals [J]. J Hum Nutr Diet, 2001, 14(2): 129136.
17.	Campbell SE, Avenell A, Walker AE. Assessment of nutritional status in hospital inpatients [J]. QJM, 2002, 95(2): 8387.
18.	张明鸣, 周勇, 伍晓汀. 生长激素短期应用对胃肠外科手术后患者营养状况和血清IGF1的影响 [J]. 中国普外基础与临床杂志, 2009, 16(12): 968973.
19.	黄承钰. 实用临床营养学 [M]. 成都: 四川大学出版社, 2006： 6983.
20.	Kudsk KA, Tolley EA, DeWitt RC, et al. Preoperative albumin and surgical site identify surgical risk for major postoperative complications [J]. JPEN J Parenter Enteral Nutr, 2003, 27(1): 19.
21.	Jones JM. The methodology of nutritional screening and assessment tools [J]. J Hum Nutr Diet， 2002, 15(1): 5971.
22.	Buzby GP, Mullen JL, Matthews DC, et al. Prognostic nutritional index in gastrointestinal surgery [J]. Am J Surg, 1980, 139(1): 160167.
23.	Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? [J]. JPEN J Parenter Enteral Nutr, 1987, 11(1): 813.
24.	Sacks GS, Dearman K, Replogle WH, et al. Use of subjective global assessment to identify nutritionassociated complications and death in geriatric longterm care facility residents [J]. J Am Coll Nutr, 2000, 19(5): 570577.
25.	Thoresen L, Fjeldstad I, Krogstad K, et al. Nutritional status of patients with advanced cancer: the value of using the subjective global assessment of nutritional status as a screening tool [J]. Palliat Med, 2002, 16(1): 3342.
26.	Norman K, Schütz T, Kemps M, et al. The subjective global assessment reliably identifies malnutritionrelated muscle dysfunction [J]. Clin Nutr, 2005, 24(1): 143150.
27.	Sungurtekin H, Sungurtekin U, Balci C, et al. The influence of nutritional status on complications after major intraabdominal surgery [J]. J Am Coll Nutr, 2004, 23(3): 227232.
28.	Sungurtekin H, Sungurtekin U, Hanci V, et al. Comparison of two nutrition assessment techniques in hospitalized patients [J]. Nutrition, 2004, 20(5): 428432.
29.	Ryu SW, Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients [J]. World J Gastroenterol, 2010, 16(26): 33103317.
30.	Guigoz Y, Vellas BJ, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients [J]. Facts Res Gerontol, 1994, 4(Suppl 2): 1559.
31.	Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The mini nutritional assessment as part of the geriatric evaluation [J]. Nutr Rev, 1996, 54(1 Pt 2): S59S65.
32.	Shum NC, Hui WW, Chu FC, et al. Prevalence of malnutrition and risk factors in geriatric patients of a convalescent and rehabilitation hospital [J]. Hong Kong Med J, 2005, 11(4): 234242.
33.	Barone L, Milosavljevic M, Gazibarich B. Assessing the older person: is the MNA a more appropriate nutritional assessment tool than the SGA? [J]. J Nutr Health Aging, 2003, 7(1): 1317.
34.	Vedantam A, Subramanian V, Rao NV, et al. Malnutrition in freeliving elderly in rural south India: prevalence and risk factors [J]. Public Health Nutr, 2010, 13(9): 13281332.
35.	Bauer JM, Vogl T, Wicklein S, et al. Comparison of the Mini Nutritional Assessment, Subjective Global Assessment, and Nutritional Risk Screening (NRS 2002) for nutritional screening and assessment in geriatric hospital patients [J]. Z Gerontol Geriatr, 2005, 38(5): 322327.
36.	吴萍, 卞大荣. 微型营养评价法与主观全面评价法的比较 [J]. 同济大学学报(医学版), 2009, 30(3): 125128.
37.	Rubenstein LZ, Harker JO, Salvà A, et al. Screening for undernutrition in geriatric practice: developing the shortform mininutritional assessment (MNASF) [J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6): M366M372.
38.	Kuzuya M, Kanda S, Koike T, et al. Evaluation of MiniNutritional Assessment for Japanese frail elderly [J]. Nutrition, 2005, 21(4): 498503.
39.	Phillips MB, Foley AL, Barnard R, et al. Nutritional screening in communitydwelling older adults: a systematic literature review [J]. Asia Pac J Clin Nutr, 2010, 19(3): 440449.
40.	Malnutrition Advisory Group. A consistent and reliable tool for malnutrition screening [J]. Nurs Times, 2003, 99(46): 2627.
41.	Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool” (“MUST”) for adults [J]. Br J Nutr, 2004, 92(5): 799808.
42.	Stratton RJ, King CL, Stroud MA, et al. “Malnutrition Universal Screening Tool” predicts mortality and length of hospital stay in acutely ill elderly [J]. Br J Nutr, 2006, 95(2): 325330.
43.	Amaral TF, Antunes A, Cabral S, et al. An evaluation of three nutritional screening tools in a Portuguese oncology centre [J]. J Hum Nutr Diet, 2008, 21(6): 575583.
44.	傅晓瑾, 路潜. 三种营养筛查工具在外科术前患者中的应用 [J]. 中国临床营养杂志, 2008, 16(6): 353356.
45.	Kondrup J, Allison SP, Elia M, et al, Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002 [J]. Clin Nutr, 2003, 22(4): 415421.
46.	Sorensen J, Kondrup J, Prokopowicz J, et al; EuroOOPS study group. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome [J]. Clin Nutr, 2008, 27(3): 340349.
47.	Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastrointestinal surgery [J]. Clin Nutr, 2008, 27(4): 565570.
48.	Valero MA, Díez L, El Kadaoui N, et al. Are the tools recommended by ASPEN and ESPEN comparable for assessing the nutritional status? [J]. Nutr Hosp, 2005, 20(4): 259267.
49.	Kyle UG, Kossovsky MP, Karsegard VL, et al. Comparison of tools for nutritional assessment and screening at hospital admission: a population study [J]. Clin Nutr, 2006, 25(3): 409417.
50.	Raslan M, Gonzalez MC, Dias MC, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients [J]. Nutrition, 2010, 26(78): 721726.
51.	于康, 夏莹, 王孟昭, 等. 营养风险筛查和主观全面评定用于肺癌非手术患者营养筛查的比较 [J]. 中国临床营养杂志， 2008, 16(6): 349352.
52.	Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals [J]. Nutrition, 2010, 26(1112): 10881093.

1. Kondrup J, Rasmussen HH, Hamberg O, et al; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials [J]. Clin Nutr, 2003, 22(3): 321336．.
2. Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics [J]. Clin Nutr, 2006, 25(2): 180186.
3. 王艳, 蒋朱明, Nolan MT, 等. 营养风险的概念分析 [J]. 中华临床营养杂志, 2009, 17(2): 104106.
4. Johansen N, Kondrup J, Plum LM, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk [J]. Clin Nutr, 2004, 23(4): 539550.
5. 中华医学会. 临床技术操作规范－肠外肠内营养学分册 [M]. 北京: 人民军医出版社, 2008: 159.
6. Green SM, Watson R. Nutritional screening and assessment tools for use by nurses: literature review [J]. J Adv Nurs, 2005, 50(1): 6983.
7. Bistrian BR, Blackburn GL, Vitale J, et al. Prevalence of malnutrition in general medical patients [J]. JAMA, 1976, 235(15): 15671570.
8. Blackburn GL, Bistrian BR, Maini BS, et al. Nutritional and metabolic assessment of the hospitalized patient [J]. JPEN J Parenter Enteral Nutr, 1977, 1(1): 1122.
9. McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital [J]. BMJ, 1994, 308(6934): 945948.
10. Fettes SB, Davidson HI, Richardson RA, et al. Nutritional status of elective gastrointestinal surgery patients pre and postoperatively [J]. Clin Nutr, 2002, 21(3): 249254.
11. 蒋朱明，陈伟，张澍田．中国11个城市大医院6个临床专科5 303例住院患者营养不良风险筛查(期中小结摘要) [J]. 中国临床营养杂志, 2006, 14(4): 263.
12. 蒋朱明，陈伟，朱赛楠，等．我国东、中、西部大城市三甲医院营养不良（不足）、营养风险发生率及营养支持应用状况调查 [J]. 中国临床营养杂志, 2008, 16(6): 335337.
13. 蒋朱明，于康，朱赛楠，等．我国东、中、西部中小医院住院患者营养不良（不足）、营养风险、超重和肥胖发生率及营养支持应用状况调查（中期小结） [J]. 中国临床营养杂志, 2008, 16(6): 338340.
14. Oliveira MR, Fogaa KC, LeandroMerhi VA. Nutritional status and functional capacity of hospitalized elderly [J]. Nutr J, 2009, 8: 54.
15. Liang X, Jiang ZM, Nolan MT, et al. Comparative survey on nutritional risk and nutritional support between Beijing and Baltimore teaching hospitals [J]. Nutrition, 2008, 24(10): 969976.
16. Mackintosh MA, Hankey CR. Reliability of a nutrition screening tool for use in elderly day hospitals [J]. J Hum Nutr Diet, 2001, 14(2): 129136.
17. Campbell SE, Avenell A, Walker AE. Assessment of nutritional status in hospital inpatients [J]. QJM, 2002, 95(2): 8387.
18. 张明鸣, 周勇, 伍晓汀. 生长激素短期应用对胃肠外科手术后患者营养状况和血清IGF1的影响 [J]. 中国普外基础与临床杂志, 2009, 16(12): 968973.
19. 黄承钰. 实用临床营养学 [M]. 成都: 四川大学出版社, 2006： 6983.
20. Kudsk KA, Tolley EA, DeWitt RC, et al. Preoperative albumin and surgical site identify surgical risk for major postoperative complications [J]. JPEN J Parenter Enteral Nutr, 2003, 27(1): 19.
21. Jones JM. The methodology of nutritional screening and assessment tools [J]. J Hum Nutr Diet， 2002, 15(1): 5971.
22. Buzby GP, Mullen JL, Matthews DC, et al. Prognostic nutritional index in gastrointestinal surgery [J]. Am J Surg, 1980, 139(1): 160167.
23. Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? [J]. JPEN J Parenter Enteral Nutr, 1987, 11(1): 813.
24. Sacks GS, Dearman K, Replogle WH, et al. Use of subjective global assessment to identify nutritionassociated complications and death in geriatric longterm care facility residents [J]. J Am Coll Nutr, 2000, 19(5): 570577.
25. Thoresen L, Fjeldstad I, Krogstad K, et al. Nutritional status of patients with advanced cancer: the value of using the subjective global assessment of nutritional status as a screening tool [J]. Palliat Med, 2002, 16(1): 3342.
26. Norman K, Schütz T, Kemps M, et al. The subjective global assessment reliably identifies malnutritionrelated muscle dysfunction [J]. Clin Nutr, 2005, 24(1): 143150.
27. Sungurtekin H, Sungurtekin U, Balci C, et al. The influence of nutritional status on complications after major intraabdominal surgery [J]. J Am Coll Nutr, 2004, 23(3): 227232.
28. Sungurtekin H, Sungurtekin U, Hanci V, et al. Comparison of two nutrition assessment techniques in hospitalized patients [J]. Nutrition, 2004, 20(5): 428432.
29. Ryu SW, Kim IH. Comparison of different nutritional assessments in detecting malnutrition among gastric cancer patients [J]. World J Gastroenterol, 2010, 16(26): 33103317.
30. Guigoz Y, Vellas BJ, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients [J]. Facts Res Gerontol, 1994, 4(Suppl 2): 1559.
31. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The mini nutritional assessment as part of the geriatric evaluation [J]. Nutr Rev, 1996, 54(1 Pt 2): S59S65.
32. Shum NC, Hui WW, Chu FC, et al. Prevalence of malnutrition and risk factors in geriatric patients of a convalescent and rehabilitation hospital [J]. Hong Kong Med J, 2005, 11(4): 234242.
33. Barone L, Milosavljevic M, Gazibarich B. Assessing the older person: is the MNA a more appropriate nutritional assessment tool than the SGA? [J]. J Nutr Health Aging, 2003, 7(1): 1317.
34. Vedantam A, Subramanian V, Rao NV, et al. Malnutrition in freeliving elderly in rural south India: prevalence and risk factors [J]. Public Health Nutr, 2010, 13(9): 13281332.
35. Bauer JM, Vogl T, Wicklein S, et al. Comparison of the Mini Nutritional Assessment, Subjective Global Assessment, and Nutritional Risk Screening (NRS 2002) for nutritional screening and assessment in geriatric hospital patients [J]. Z Gerontol Geriatr, 2005, 38(5): 322327.
36. 吴萍, 卞大荣. 微型营养评价法与主观全面评价法的比较 [J]. 同济大学学报(医学版), 2009, 30(3): 125128.
37. Rubenstein LZ, Harker JO, Salvà A, et al. Screening for undernutrition in geriatric practice: developing the shortform mininutritional assessment (MNASF) [J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6): M366M372.
38. Kuzuya M, Kanda S, Koike T, et al. Evaluation of MiniNutritional Assessment for Japanese frail elderly [J]. Nutrition, 2005, 21(4): 498503.
39. Phillips MB, Foley AL, Barnard R, et al. Nutritional screening in communitydwelling older adults: a systematic literature review [J]. Asia Pac J Clin Nutr, 2010, 19(3): 440449.
40. Malnutrition Advisory Group. A consistent and reliable tool for malnutrition screening [J]. Nurs Times, 2003, 99(46): 2627.
41. Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool” (“MUST”) for adults [J]. Br J Nutr, 2004, 92(5): 799808.
42. Stratton RJ, King CL, Stroud MA, et al. “Malnutrition Universal Screening Tool” predicts mortality and length of hospital stay in acutely ill elderly [J]. Br J Nutr, 2006, 95(2): 325330.
43. Amaral TF, Antunes A, Cabral S, et al. An evaluation of three nutritional screening tools in a Portuguese oncology centre [J]. J Hum Nutr Diet, 2008, 21(6): 575583.
44. 傅晓瑾, 路潜. 三种营养筛查工具在外科术前患者中的应用 [J]. 中国临床营养杂志, 2008, 16(6): 353356.
45. Kondrup J, Allison SP, Elia M, et al, Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002 [J]. Clin Nutr, 2003, 22(4): 415421.
46. Sorensen J, Kondrup J, Prokopowicz J, et al; EuroOOPS study group. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome [J]. Clin Nutr, 2008, 27(3): 340349.
47. Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastrointestinal surgery [J]. Clin Nutr, 2008, 27(4): 565570.
48. Valero MA, Díez L, El Kadaoui N, et al. Are the tools recommended by ASPEN and ESPEN comparable for assessing the nutritional status? [J]. Nutr Hosp, 2005, 20(4): 259267.
49. Kyle UG, Kossovsky MP, Karsegard VL, et al. Comparison of tools for nutritional assessment and screening at hospital admission: a population study [J]. Clin Nutr, 2006, 25(3): 409417.
50. Raslan M, Gonzalez MC, Dias MC, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients [J]. Nutrition, 2010, 26(78): 721726.
51. 于康, 夏莹, 王孟昭, 等. 营养风险筛查和主观全面评定用于肺癌非手术患者营养筛查的比较 [J]. 中国临床营养杂志， 2008, 16(6): 349352.
52. Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals [J]. Nutrition, 2010, 26(1112): 10881093.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Nutritional Status in Hospitalized Patients

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