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Clinical nutrition

Comparison of the efficacy of Nutritional Risk Screening 2002 and Mini Nutritional Assessment Short Form in recognizing sarcopenia and predicting its mortality

Abstract

Objective

This study aimed to examine the efficacy of Nutritional Risk Screening 2002 (NRS2002) and Mini Nutritional Assessment Short Form (MNA-SF) in recognizing sarcopenia and predicting its mortality in Chinese geriatric hospitalized patients.

Methods

A prospective analysis was performed in 430 hospitalized geriatric patients. Nutrition status was assessed using the NRS2002 and MNA-SF scales. Anthropometric measures and biochemical parameters were carried out for each patient. Sarcopenia was defined according to the revised consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP2). Patients were follow-up for up to 26 months.

Results

The overall prevalence of sarcopenia was 35.3% in this population. In the sarcopenic patients, 53 (34.9%) were malnutrition/nutritional risk according to NRS2002 assessment and 101 (66.4%) patients were malnutrition/nutritional risk according to MNA-SF assessment. NRS2002 vs MNA-SF showed moderate agreement (κ = 0.460, P < 0.001). Receiver operating characteristic analysis showed that the area under the curve of MNA-SF was larger than NRS2002 in recognizing sarcopenia (0.763 vs 0.649, P = 0.001). During a median follow-up time of 20.22 months, 48 (31.6%) sarcopenic patients died. The Kaplan–Meier curve demonstrated that malnutrition/nutritional risk patients according to whether NRS2002 or MNA-SF assessment had a higher risk of death than the normal nutrition patients (χ2 = 15.728, P < 0.001; χ2 = 7.039, P = 0.008, respectively). Age, serum albumin levels, and NRS2002 score were independent factors influencing the mortality.

Conclusion

MNA-SF score may be better than the NRS2002 score to recognize sarcopenia in Chinese geriatric population. Both NRS2002 and MNA-SF scores could predict mortality, but NRS2002 score was the independent predict factor.

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Fig. 1: Comparison of CC levels in three groups.
Fig. 2: ROC curve analysis of NRS2002 and MNA-SF for sarcopenia.
Fig. 3: Kaplan–Meier analysis for sarcopenic patients’ mortality.

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Acknowledgements

We thank all the team involved in the development and implementation of the study: Jin Wang, Caihua Zhang, Xuelian Chen, Xiaokang Sun, and Ji Li.

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Contributions

The paper was conceived by author XLZ. XLZ, ZZ, YXZ, YYW, YYK, CXR and JX contributed to the implementation of the program and acquisition of the data. YXZ and JT performed the statistical analysis. XLZ and ZZ wrote the paper. XLZ finalized the paper. All authors contributed to the interpretation of data analysis, drafted or reviewed the paper and approved this version for publication.

Corresponding author

Correspondence to Xiao-yan Zhang.

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Zhang, Xl., Zhang, Z., Zhu, Yx. et al. Comparison of the efficacy of Nutritional Risk Screening 2002 and Mini Nutritional Assessment Short Form in recognizing sarcopenia and predicting its mortality. Eur J Clin Nutr 74, 1029–1037 (2020). https://doi.org/10.1038/s41430-020-0621-8

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