The MUST, MST, and SNAQ share similar accuracy to the NRS-2002 in identifying risk of malnutrition, and all instruments were positively associated with very long hospital stay. In clinical practice, the 4 tools could be applied, and the choice for one of them should be made per the particularities of the service.
Introduction: Hospital malnutrition is associated with the worsening of the patient’s general
condition and its early diagnosis allows the reduction of related complications. The aim of this study
was to verify the agreement of the Short Nutritional Assessment Questionnaire (SNAQ) screening
tool and the Subjective Global Assessment (SGA). Methods: Cross-sectional study, carried out in
a general hospital in the city of Porto Alegre (RS). The SNAQ was applied by previously trained
nutritionists and nurses, and the patient was considered at nutritional risk when the score was ≥2.
SGA was applied by nutritionists in all patients and considered the gold standard for comparison.
The Kappa coefficient was used to assess the degree of agreement between the screening and
nutritional assessment tools. Kappa values between 0.21-0.60 were considered as low agreement, 0.61-0.8 as moderate agreement and greater than 0.81, as strong agreement. Results:
Between January and March 2017, 186 patients were evaluated, of them 115 (62%) were women.
The mean age was 65.7 ± 16.6 years and the body mass index (BMI) mean was 26.5 ± 5.5 kg/
m². According to SGA classification, 73.7% of the sample was considered to be well nourished,
14% moderately malnourished and 12.4% severely malnourished. Low agreement was observed
between the nutritional risk diagnosed by nursing vs. nutrition through SNAQ (Kappa=0.58) and
good agreement of SNAQ applied by the nutrition team with the nutritional diagnosis of SGA
(Kappa=0.73). The SNAQ presented sensitivity of 85.7% (95% CI 73.3 - 92.9) and specificity of
90.5% (95% CI 84.4 - 94.4); positive predictive value of 76.4% (95% CI 65.7 - 84.5) and negative
predictive value of 94.7% (95% CI 90 - 97.2). Conclusion: We conclude that the screening tool
SNAQ when conducted by nutritionists can be used for early detection of hospital malnutrition.
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