Nutritional Diagnosis: comparison between Nutrition Risk Screening (NRS2002) protocol and the Nutrition Assessment system of Hospital de Clínicas de Porto Alegre (AN-HCPA)

Abstract

Introduction: Malnutrition during hospitalization is highly prevalent and remains poorly identified. There is no agreement on the best method to assess the nutritional status of hospitalized patients. Objectives: To identify the agreement level of the nutritional diagnosis when patients are evaluated using Nutrition Risk Screening (NRS-2002) protocol and the one used at Hospital de Clínicas de Porto Alegre (AN-HCPA). Methods: Cross-sectional study of patients with malnutrition and eutrophy diagnoses. The evaluations were performed at distinct moments, by different researchers. Results: The study involved 247 patients of 50.7 ± 15.5 years and BMI of 21.31 ± 2.1 kg/m2. NRS-2002 classified 43% of patients with eutrophy and 57% with malnutrition. AN-HCPA identified 50% of patients with eutrophy and 50% with malnutrition. Both systems agreed in 93 cases (38%) for eutrophy diagnosis and in 110 cases (45%) for malnutrition diagnosis, with Kappa coefficient of 0.64 (95% CI 0.55-0.74) p < 0.001. AN-HCPA presented a sensitivity of 78.6% and a specificity of 86.9%, positive predictive value of 88.7% and negative predictive value of 75.6%. Conclusion: The results showed that AN-HCPA has a good level of agreement with the reference method and is a fast and easy-to-use tool that can be recommended as a sensitive instrument to identify the nutritional status of hospitalized patients.