Abstract

Purpose: Although a number of validated nutritional risk screening tools are available, there is no gold standard for cancer patients, and most tools may not be applicable to the Korean population. To address this limitation, the Chonnam National University Hwasun Hospital developed an electronic nutritional risk screening tool for hospital cancer patients called the Chonnam National University Hwasun Hospital?Nutritional Risk Screening Tool (CNUHH-NRST). This study assesses the validity of the CNUHH-NRST by comparing it with Nutritional Risk Screening (NRS 2002) and the Malnutrition Screening Tool (MST).
Materials and Methods: A total of 529 cancer patients admitted in January 2010 were independently rated as not at risk or at risk of malnutrition by using the CNUHH-NRST, NRS 2002, and the MST. The cross-validity of the CNUHH-NRST was established, and secondary validation was conducted based on biochemical nutritional markers and clinical outcomes.
Results: The results indicate that 15.3%, 22.3%, and 16.6% of the patients were classified as at risk of malnutrition by the CNUHH-NRST, NRS 2002, and the MST, respectively. The sensitivity and specificity of the CNUHH-NRST relative to NRS 2002 and the MST were 66.1% and 99.3% and 70.5% and 95.7%, respectively. The kappa values were 0.74 and 0.68 (P<0.001). In comparison with the patients at no risk of malnutrition, those at risk showed lower serum albumin, total lymphocyte counts, and hemoglobin (P<0.05); a longer hospital stay (P<0.001); and higher mortality rates (P<0.001).
Conclusion: The CNUHH-NRST shows acceptable validity in comparison with NRS 2002 and the MST. In addition, the CNUHH-NRST can be used easily and quickly because it is an automated system based on electronic medical records. Further validation using a nutritional risk assessment tool is needed. (SMN 2012;3:16-22)

• Keywords: Hospital cancer patients, Nutritional risk screening, Malnutrition