Screening Nutritional Status of Hospitalized Patients With Nutritional Risk Screening 2002 and Subjective Global Assessment Tools
Conditions: Malnourishment
Sponsor: TC Erciyes University

 
 
 
 
Screening Nutritional Status of Hospitalized Patients With 
Nutritional Risk Screening 2002 and Subjective Global 
Assessment Tools 
 
 
 
 
 
 
 
 
 
 
 
Document Date: December 1, 2016 
 
 
 
 
 
 
 

Materials and methods 
 
Participants 
The study was conducted with 134 adult patients (male/female: 59/75) who were hospitalized 
in the clinics (hematology, neurology, gastroenterology, nephrology, endocrine, pulmonary 
disease and cardiology) of Malatya Training and Research Hospital between January 1 and 
August 30, 2016.  
The exclussion criteria included: patients were (i) < 18 years old, (ii) hospitalized due to surgical 
operation, (iii) pregnant women, (iv) breastfeeding women, (v) bed-dependent, (vi) suffered an 
advanced disease that required palliative care. 
The study was approved by the Ethics Committee of [removed for blind peer review]. A written 
informed consent was obtained from the patients. 
 
Study design 
In the cross-sectional study demographic data (age, gender), BMI, cause of hospitalization and 
hospital LOS were recorded. For the nutritional assessment all patients were screened with NRS 
2002 and SGA within the first days of admission to the patients. And also the edema and the 
acid were evaluated by the physician. The primary predictors of interest in our study were the 
NRS 2002 and SGA results of paients. 
In the begining 168 patients were included to study but, 34 patients did not complete scanning 
procces by the reason of missing data and excluded from the study. Finally 134 patients 
completed the nutritional scanning (Fig.1).   
 
BMI classification 
BMI as an objective measurement, refers to the weight for height, which is valid for both 
genders and all age groups. BMI classification according to WHO refers to, <16,5 kg/m² severe 
malnourished, 18.5 kg/m²  malnourished, 18.5-24.9 kg/m² normal, 25-29.9 kg/m² overweight, 
≥30 kg/m² obese in adults (9). ESPEN recognises malnutrition as, patient has  (i) weight loss > 
% 10 – 15 of body weight in last 6 months; (ii) BMI < 18.5 kg/m²; (iii) level B and C (mild-to-
moderate and severe malnourished) accordig to SGA or score ≥3 according to NRS 2002; (iv) 
serum albumin < 30 g/L (out of hepatic and renal disfunction) (10). 
 
 

Nutritional status 
Nutritional status of all patients were screened both NRS 2002 and SGA within the first days 
of admission to the patients.  
The patients were classified as being nutritionally risk (NRS+): total score ≥ 3 or nutritionally 
risk-free (NRS-): total score < 3 according to NRS 2002 results.  
The SGA screening normally provides three alternative categories for nutritional classification: 
well nourished (A); mild-to-moderately malnourished (B); or severely malnourished (C). 
In order to facilitate the analysis of the influence of the nutritional status on the outcomes, to 
allow comparison with the NRS 2002 and SGA, patients were grouped as being either non-
malnourished (A) or malnourished (B or C; included mild-to-moderately malnourished and 
severely malnourished according to SGA results). And according to the results of two screening 
tools, patients were grouped as being malnourished [included patients on (NRS+) or SGA (B 
or C)] and non-malnourished [included patients on (NRS-) or SGA (A)].  
 
Statistics 
The sample size was calculated as minimum 88 patients based on the primary outcome variable: 
the detection of a 5% difference between the nutritional status and NRS 2002 and SGA tools 
and statistical power of 95%. Continuous variables were expressed as the mean and standard 
deviation. Statistical differences between groups were assessed using Chi-Square and Fisher 
exact tests for categorical variables, while the Student's t-test was used for continuous variables. 
In order to analyze which variables affected the prevalence of malnutrition, a logistic regression 
analysis was performed, in which malnutrition according to the NRS 2002 and SGA was 
considered the dependent variable seperately. The level of significance used was 0.05. 
Statistical analysiswas carried out with IBM SPSS Statistics 22.0.