Nutritional risk screening in hospitalized patients with heart failure

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2015-04, Vol.34 (2), p.257-264
• Main Authors: Tevik, Kjerstin, Thürmer, Hanne, Husby, Marit Inderhaug, de Soysa, Ann Kristin, Helvik, Anne-Sofie
• Format: Article
• Language: English
• Subjects: Adult; Aged; Complications; Cross-Sectional Studies; Disease-related malnutrition in hospital; Edema - etiology; Female; Gastroenterology and Hepatology; Heart failure; Heart Failure - complications; Heart Failure - mortality; Heart Failure - physiopathology; Hospital Mortality; Humans; Length of stay; Length of Stay - statistics & numerical data; Male; Malnutrition - complications; Malnutrition - mortality; Middle Aged; Multivariate regression analysis; Nutrition Assessment; Nutritional risk screening (NRS-2002); Nutritional Status; Prevalence; Reproducibility of Results; Risk Assessment
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2014.03.014

Summary Background & aims Malnutrition is an important issue in patient outcome. Screening tools to find risk patients need to be evaluated. This study looks at the validity and reliability of nutritional risk screening (named NRS-2002) in hospitalized patients with chronic heart failure. Methods In this cross-sectional study nutritional screening was performed using NRS-2002 in 131 patients with chronic heart failure. The predictive validity was evaluated in relation to whether NRS-2002 predicted the incidence of complications and length of hospital stay. NRS-2002's ability to locate nutritional risk in patients with edema was evaluated. The inter-rater reliability was measured between three investigators screening 45 patients each. Results The prevalence of nutritional risk was 57%. The incidence of complications and the median length of hospital stay were significantly higher in patients at nutritional risk compared to patients not at nutritional risk. Only the component of severity of disease in NRS-2002 and not the component of the nutritional status was associated with increased length of hospital stay in multivariate analysis. Patients with edema were classified correctly regarding nutritional risk status by NRS-2002 in all but one occasion. The inter-rater reliability was documented, kappa >0.60. Conclusion NRS-2002 was a reliable screening tool in an in-patient sample with chronic heart failure. The validity of NRS-2002 needs further investigation in a larger sample of hospitalized patients with chronic heart failure.