Development of a valid and reliable malnutrition screening tool for adult acute hospital patients

Nutrition screening identifies individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutrition support. The ai m of this study was to develop a simple, reliable and valid malnutrition sc reening tool that could be used at hospital admission to identify adult acu te patients at risk of malnutrition. The sample population included 408 pat ients admitted to an Australian hospital, excluding pediatric, maternity, a nd psychiatric patients. The ability of various nutrition screening questio ns to predict subjective global assessment (SGA) were examined in contingen cy tables. The combination of nutrition screening questions with the highes t sensitivity and specificity at predicting SGA was termed the malnutrition screening tool (MST), and consisted df two questions regarding appetite an d recent unintentional weight loss. Subjects who were at risk of malnutriti on according to the MST had significantly lower mean values for the objecti ve nutrition parameters (except immunologic parameters) and longer length o f stays than subjects who were not at risk of malnutrition. Therefore conve rgent and predictive validity of the MST was established. The interrater re liability of the malnutrition screening tool was high (93-97%). The MST is a simple, quick, valid, and reliable tool which can be used to identify pat ients at risk of malnutrition. (C) Elsevier Science Inc. 1999.