Validity of the new nutrition screening tool Control of Food Intake, Protein, and Anthropometry (CIPA) in non-surgical inpatients

Abstract

IntroductionThere is no gold-standard method for hospital nutrition screening. The new screening tool termed Control of Food Intake, Protein, and Anthropometry (CIPA) gives positive results when at least one of the following parameters is met: control of food intake for 72 h < 50%, serum albumin < 3 g/dl, body mass index < 18.5 kg/m2 or mid-upper arm circumference ≤ 22.5 cm. This method was validated in comparison with Subjective Global Assessment (SGA) in hospitalized patients with non-surgical pathologies.Material and methodsA prospective, longitudinal study was performed on 221 consecutively enrolled patients. Prevalence or risk of malnutrition was estimated with CIPA vs. SGA screening at hospital admission and the concordance (k index – K) between the two methods and their sensitivity (S) and specificity (SP) were studied. Mean length of stay (LOS), mortality, and rate of early readmission were analyzed.ResultsThe prevalence or risk of malnutrition identified by CIPA and SGA was 35.7% and 23.1%, respectively. K was 0.401 (p < 0.001); S and SP of CIPA vs. SGA were 72.5% and 75.3%, respectively. In contrast to SGA, CIPA-positive patients had an increased mean LOS compared to the negative ones (19.53 vs. 12.63 days, p < 0.001). Both methods detected a major risk of mortality in positive patients, but no difference in early readmission.ConclusionsThe CIPA and the SGA screening tools detect patients with a higher risk of mortality, but only CIPA identifies patients with an increased mean LOS. CIPA screening proved valid for use in non-surgical inpatients.

Cost-effectiveness of the hospital nutrition screening tool CIPA

“…We had observed positive outcomes in 23-38% of the patients in former studies conducted with the CIPA screening tool [7,8,11] and yet, in this work, the proportion was below 20%. This translated into a number of nutritional treatments -the basis for improvement in the clinical prognosis of malnourished patients -lower than expected.…”

“…A nutrition screening tool called CIPA (Control of Food Intake, Protein, Anthropometry) was designed, validated, and implemented taking advantage of tools that are commonly used in clinical practice. This screening method gives a positive result if one of the following premises is met: 1) control of food intake for 48-72 h with intake less than 50%, 2) serum albumin < 3 g/dl, 3) body mass index (BMI) < 18.5 kg/m 2 or mid-upper arm circumference ≤ 22.5 cm (in patients who cannot be weighed or measured) [7][8][9][10][11].…”

Comparison of Clinical Outcomes in Surgical Patients Subjected to CIPA Nutrition Screening and Treatment versus Standard Care

“…The CIPA tool detected that 22.3% of the patients were malnourished or at risk, and they were treated accordingly. These were somewhat less than observed with the same tool in nonsurgical patients [18]. The proportion of malnutrition in surgical patients given in the literature varies across the types of surgery and whether or not they are oncological.…”

“…The Control of Food Intake, Protein, and Anthropometry (CIPA) nutrition screening tool has been optimized and validated in several studies, even though it has only been evaluated in nonsurgical patients so far [16,17,18,19,20]. Results are positive when one of the following premises are met in a hospitalized patient: (1) food intake <50% during a 48–72 h period; (2) serum albumin <3 g/dL; (3) body mass index (BMI) <18.5 kg/m 2 or mid-upper arm circumference (MUAC) ≤22.5 cm (in patients who cannot not be weighed or measured).…”

Influence of the Results of Control of Intakes, Proteins and Anthropometry Nutritional Screening, Sarcopenia and Body Composition on the Clinical Evolution of Hospitalized Patients

“…A mortality of 17.3% of the total sample was observed at 6 months, 7.5% of early readmission and a median stay of 14 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) days.…”