The prevalence of malnutrition remains high in hospitals but no “gold standard” has been established to identify nutritional risks adequately. The Nutrition Risk Screening-2002 (NRS-2002), Subjective Global Assessment (SGA), and Controlling Nutritional Status Index (CONUT) are widely used screening tools, but their efficacy has not yet been compared in Mexican patients. Here, we aimed to compare the efficacy of these tools in identifying nutritional risks within the first 48 h of admission in a group of patients with gastrointestinal diseases. This was a cross-sectional study of 196 patients. The results of the screening tools, length of hospital stay, serum albumin and cholesterol concentrations, lymphocyte counts, age, body mass index (BMI), complications, and mortality were analyzed. Kappa (κ) statistics were applied to determine the degree of agreement between tools. The performances of the screening tools in predicting complications and mortality were assessed using binary logistic regression. The NRS-2002, SGA, and CONUT tools identified nutritional risk in 67, 74, and 51% of the patients, respectively. The observed agreements between tools were: NRS2002/SGA, κ = 0.53; CONUT/NRS-2002, κ = 0.42; and SGA/CONUT, κ = 0.36. Within age groups, the best agreement was found in those aged 51–65 years (κ = 0.68). CONUT and length of stay were both predictive for the number of complications. The number of complications and serum cholesterol concentrations were predictive for mortality. The proportion of patients identified as having nutritional risk was high using all three screening tools. SGA, NRS-2002, and CONUT had similar capacities for screening risk, but the best agreement was observed between NRS-2002 and SGA. Only CONUT predicted complications, but none of these tools performed well in predicting mortality.

中文翻译：

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比较评估墨西哥消化系统疾病患者营养风险和预测临床结果的营养筛查工具


医院中营养不良的患病率仍然很高，但尚未建立充分识别营养风险的“黄金标准”。营养风险筛查-2002 (NRS-2002)、主观总体评估 (SGA) 和控制营养状况指数 (CONUT) 是广泛使用的筛查工具，但尚未在墨西哥患者中比较其疗效。在这里，我们的目的是比较这些工具在一组胃肠道疾病患者入院后 48 小时内识别营养风险方面的效果。这是一项针对 196 名患者的横断面研究。分析了筛查工具、住院时间、血清白蛋白和胆固醇浓度、淋巴细胞计数、年龄、体重指数（BMI）、并发症和死亡率的结果。 Kappa (κ) 统计数据用于确定工具之间的一致性程度。使用二元逻辑回归评估筛查工具在预测并发症和死亡率方面的性能。 NRS-2002、SGA 和 CONUT 工具分别识别出 67%、74% 和 51% 患者的营养风险。观察到的工具之间的一致性为：NRS2002/SGA，κ = 0.53； CONUT/NRS-2002，κ = 0.42； SGA/CONUT，κ = 0.36。在年龄组中，51-65 岁的人群最为一致 (κ = 0.68)。 CONUT 和住院时间均可预测并发症的数量。并发症的数量和血清胆固醇浓度可预测死亡率。使用这三种筛查工具，被确定为具有营养风险的患者比例很高。 SGA、NRS-2002 和 CONUT 具有相似的风险筛查能力，但 NRS-2002 和 SGA 之间的一致性最佳。 只有 CONUT 可以预测并发症，但这些工具在预测死亡率方面均表现不佳。