Table 4.
Parameters of nutritional screening tools used in the included studies.
| Tool | Criteria | Score | Applications |
|---|---|---|---|
| NRI | NRI = (1.519 × serum albumin (g/L) + 41.7 × (present weight/usual weight) | No NR > 100. Mild risk: 97.5–100. Moderate risk: 83.5–97.5. High risk < 83.5. |
Recommended settings: hospital, and home care. |
| GNRI | GNRI = (14.89 × albumin (g/dL)) + (41.7 × (body weight/ideal body weight)) | Low NR 92–≤98. Moderate NR: 82–<92. High NR <82. | Recommended settings: hospital. |
| MUST | Three domains: BMI, weight loss, and consequences of disease severity. Each parameter can be rated as 0, 1, or 2. BMI domain: BMI (kg/m2) > 20 (0), 18.5–20.0 (1), <18.5 (2). Unintentional weight loss in past 3–6 months (%): <5 (0), 5–10 (1), >10 (2). Disease severity domain: drastic reduction of food consumption or inability to eat on more than five days (2). |
Low NR: 0. Medium NR: 1. High NR ≥ 2. | Recommended settings: hospital, home care, and community. |
| NRS-2002 | Two domains: disease severity score and nutritional score. Disease severity score domain: patients with diabetes, cancer, COPD (1 point); patients with severe pneumonia (2 points); intensive care patients (APACHE > 10) (3 points). Nutritional score domain: Weight loss greater than 5% in the last three months or food intake between 50% and 75% of nutritional needs (1 point); weight loss greater than 5% in the last two months, food intake between 25% and 60% of nutritional needs, or BMI 18.5–20.5 with impaired general health (2 points); weight loss greater than 5% in one month, >15% in three months, or food intake between 0% and 25% of nutritional needs (3 points). Score adjusted for age: if ≥70 years, one additional point. |
NR: score ≥ 3. | Recommended settings: hospital, home care, and community. |
| NUTRIC score | Six domains: age, APACHE, SOFA, number of comorbidities, days from hospital to ICU admission, and IL-6. Age: <50 (0); 50–74 (1); ≥75 (2). APACHE II: <15 (0); 15–19 (1); 20–28 (2); ≥28 (3). SOFA: <6 (0); 6–9 (1); ≥10 (2). Number of comorbidities: 0–1 (0); ≥2 (1). Days from hospital to ICU admission: 0–<1 (0); ≥(1). IL-6: 0-<400 (0); ≥400 (1). |
Score with IL-6: Low NR: 0–5. High NR: 6–10. Score without IL-6: Low NR: 0–4. High NR: 5–9. |
Recommended settings: critically ill patients (ICU). |
| MNA-sf | Six domains: decrease in food intake, weight loss, mobility, disease severity, neuropsychological problems (depression, dementia), and BMI. Decrease in food intake: severe (0); moderate (1); none (2). Involuntary weight loss during the last three months? >3 kg (0); does not know (1); 1–3 kg (2); none (3). Mobility: bedridden (0); able to get out of bed/chair but does not go out (1); goes out (2). Disease severity: acute disease or psychological stress in the past 3 months (0); no acute disease or psychological stress in the past 3 months (2). Neuropsychological problems: severe depression or dementia (0); mild dementia (1); none (2). BMI (kg/m2): <19 (0); <21 (1); <23 (2); ≥23 (3). |
Normal: 12–14. Risk of malnutrition: 8–11. Malnutrition: 0–7. |
Recommended settings: hospital, home care, and community. |
| MNA | 18 domains: decrease in food intake, weight loss, mobility, disease severity, neuropsychological problems (depression, dementia), and BMI (For these domains, same criteria as in the MNA-sf.). Other domains: lives independently, medication, pressure sores or skin ulcers, number of full meals daily, markers for protein intake, fruit or vegetable consumption, fluid intake, mode of feeding, self-view of nutritional status, self-assessment of health status, mid-arm circumference in cm, and calf circumference in cm. | Normal: 24–30. At risk of malnutrition: 17–23.5. Malnutrition < 17. | Recommended settings: hospital, home care, and community. |
Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; BMI, body mass index; COPD, chronic obstructive pulmonary disease; GNRI, Geriatric Nutritional Risk Index; ICU, intensive care unit; IL-6, Interleukin-6; MNA, Mini Nutritional Assessment; MNA-sf, Mini Nutritional Assessment-short form; MUST, Malnutrition Universal Screening Tool; NRI, Nutritional Risk Index; NRS-2002, Nutritional Risk Screening tool 2002; NUTRIC score, modified Nutrition Risk in the Critically ill (mNUTRIC) score; NR, nutritional risk; SOFA, Sequential Organ Failure Assessment score.