Table 1.

Nutritional Risk Screening 2002. APACHE: acute physiology and chronic health evaluation; BMI: body mass index; COPD: chronic obstructive pulmonary disease; ONS: oral nutritional supplement.

Pre-Screening
Is the BMI of the patient < 20.5 kg/m2			Yes
Did the patient lose weight in the past 3 months?			Yes
Was the patient’s food intake reduced in the past week?			Yes
Is the patient critically ill?			Yes
If yes to one of those questions, proceed to screening.
If no for all answers, the patient should be re-screened weekly.
Screening
Nutritional status	score	Stress metabolism (severity of the disease)	score
None	0	None	0
Mild Weight loss >5% in 3 months OR 50–75% of the normal food intake in the last week	1	Mild stress metabolism	1
		Patient is mobile Increased protein requirement can be covered with oral nutrition Hip fracture, chronic disease especially with complications e.g., liver cirrhosis, COPD, diabetes, cancer, chronic hemodialysis
Moderate	2	Moderate stress metabolism	2
Weight loss >5% in 2 months OR BMI 18.5–20.5 kg/m2 AND reduced general condition OR 25–50% of the normal food intake in the last week		Patient is bedridden due to illness Highly increased protein requirement, may be covered with ONS Stroke, hematologic cancer, severe pneumonia, extended abdominal surgery
Severe Weight loss >5% in 1 month OR BMI <18.5 kg/m2 AND reduced general condition OR 0–25% of the normal food intake in the last week	3	Severe stress metabolism Patient is critically ill (intensive care unit) Very strongly increased protein requirement can only be achieved with (par)enteral nutrition APACHE-II >10, bone marrow transplantation, head traumas	3
Total (A)		Total (B)
Age
<70 years: 0 pt
≥70 years: 1 pt
TOTAL = (A) + (B) + Age
≥3 points: patient is at nutritional risk. Nutritional care plan should be set up
<3 points: repeat screening weekly