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Do the malnutrition universal screening tool (MUST) and Birmingham nutrition risk (BNR) score predict mortality in older hospitalised patients?

Henderson S, Moore N, Lee E, Witham MD - BMC Geriatr (2008)

Bottom Line: Time to death was obtained from the Scottish Death Register and compared across strata of risk. 115 patients were analysed, mean age 82.1 years. 39/115 (34%) were male. 20 patients were identified as high risk by both methods of screening.MUST category significantly predicted death (log rank test, p = 0.022).The MUST score, but not the BNR, is able to predict increased mortality in older hospitalised patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee, UK. shenderson@nhs.net

ABSTRACT

Background: Undernutrition is common in older hospitalised patients, and routine screening is advocated. It is unclear whether screening tools such as the Birmingham Nutrition Risk (BNR) score and the Malnutrition Universal Screening Tool (MUST) can successfully predict outcome in this patient group.

Methods: Consecutive admissions to Medicine for the Elderly assessment wards in Dundee were assessed between mid-October 2003 and mid-January 2004. Body Mass Index (BMI), MUST and BNR scores were prospectively collected. Time to death was obtained from the Scottish Death Register and compared across strata of risk.

Results: 115 patients were analysed, mean age 82.1 years. 39/115 (34%) were male. 20 patients were identified as high risk by both methods of screening. A further 10 were categorised high risk only with the Birmingham classification and 12 only with MUST.80/115 (67%) patients had died at the time of accessing death records. MUST category significantly predicted death (log rank test, p = 0.022). Neither BMI (log rank p = 0.37) or Birmingham nutrition score (log rank p = 0.35) predicted death.

Conclusion: The MUST score, but not the BNR, is able to predict increased mortality in older hospitalised patients.

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Related in: MedlinePlus

Survival curves stratified by risk category of MUST score. Log rank: chi-squared 5.28, df = 1, p = 0.022.
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Figure 2: Survival curves stratified by risk category of MUST score. Log rank: chi-squared 5.28, df = 1, p = 0.022.

Mentions: 77/115 (67%) patients had died at the time of accessing death records; data are given in Table 2. Estimated median time to death from admission was 446 days (95% confidence interval 234 to 658 days). Median length of stay was 23 days (interquartile range 32 days; range 0–433 days). Survival curves stratified by risk category are shown in Figs 1 and 2. MUST risk category was shown to significantly predict mortality (log rank test, p = 0.022), whereas the BNR did not (log rank, p = 0.35). Furthermore, no statistically significant association was identified between BMI at admission and mortality (log rank p = 0.37). Table 2 gives hazard ratios for mortality calculated using Cox regression analysis adjusted for age and sex. Length of stay correlated with BMI category (r = -0.27, p = 0.003, Spearman's rho), but not with either MUST (r = 0.10, p = 0.37, Spearman's rho) or BNR (r = 0.10, p = 0.27, Spearman's rho) risk categories.


Do the malnutrition universal screening tool (MUST) and Birmingham nutrition risk (BNR) score predict mortality in older hospitalised patients?

Henderson S, Moore N, Lee E, Witham MD - BMC Geriatr (2008)

Survival curves stratified by risk category of MUST score. Log rank: chi-squared 5.28, df = 1, p = 0.022.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2572058&req=5

Figure 2: Survival curves stratified by risk category of MUST score. Log rank: chi-squared 5.28, df = 1, p = 0.022.
Mentions: 77/115 (67%) patients had died at the time of accessing death records; data are given in Table 2. Estimated median time to death from admission was 446 days (95% confidence interval 234 to 658 days). Median length of stay was 23 days (interquartile range 32 days; range 0–433 days). Survival curves stratified by risk category are shown in Figs 1 and 2. MUST risk category was shown to significantly predict mortality (log rank test, p = 0.022), whereas the BNR did not (log rank, p = 0.35). Furthermore, no statistically significant association was identified between BMI at admission and mortality (log rank p = 0.37). Table 2 gives hazard ratios for mortality calculated using Cox regression analysis adjusted for age and sex. Length of stay correlated with BMI category (r = -0.27, p = 0.003, Spearman's rho), but not with either MUST (r = 0.10, p = 0.37, Spearman's rho) or BNR (r = 0.10, p = 0.27, Spearman's rho) risk categories.

Bottom Line: Time to death was obtained from the Scottish Death Register and compared across strata of risk. 115 patients were analysed, mean age 82.1 years. 39/115 (34%) were male. 20 patients were identified as high risk by both methods of screening.MUST category significantly predicted death (log rank test, p = 0.022).The MUST score, but not the BNR, is able to predict increased mortality in older hospitalised patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee, UK. shenderson@nhs.net

ABSTRACT

Background: Undernutrition is common in older hospitalised patients, and routine screening is advocated. It is unclear whether screening tools such as the Birmingham Nutrition Risk (BNR) score and the Malnutrition Universal Screening Tool (MUST) can successfully predict outcome in this patient group.

Methods: Consecutive admissions to Medicine for the Elderly assessment wards in Dundee were assessed between mid-October 2003 and mid-January 2004. Body Mass Index (BMI), MUST and BNR scores were prospectively collected. Time to death was obtained from the Scottish Death Register and compared across strata of risk.

Results: 115 patients were analysed, mean age 82.1 years. 39/115 (34%) were male. 20 patients were identified as high risk by both methods of screening. A further 10 were categorised high risk only with the Birmingham classification and 12 only with MUST.80/115 (67%) patients had died at the time of accessing death records. MUST category significantly predicted death (log rank test, p = 0.022). Neither BMI (log rank p = 0.37) or Birmingham nutrition score (log rank p = 0.35) predicted death.

Conclusion: The MUST score, but not the BNR, is able to predict increased mortality in older hospitalised patients.

Show MeSH
Related in: MedlinePlus