Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Ad Hoc ESPEN Working Group., et al.
Clinical nutrition (Edinburgh, Scotland). Date of publication 2003 Jun 1;volume 22(3):321-36.
1. Clin Nutr. 2003 Jun;22(3):321-36.
Nutritional risk screening (NRS 2002): a new method based on an analysis of
controlled clinical trials.
Kondrup J(1), Rasmussen HH, Hamberg O, Stanga Z; Ad Hoc ESPEN Working Group.
Author information:
(1)Nutrition Unit, Rigshospitalet, Copenhagen, Denmark.
BACKGROUND & AIMS: A system for screening of nutritional risk is described. It is
based on the concept that nutritional support is indicated in patients who are
severely ill with increased nutritional requirements, or who are severely
undernourished, or who have certain degrees of severity of disease in combination
with certain degrees of undernutrition. Degrees of severity of disease and
undernutrition were defined as absent, mild, moderate or severe from data sets in
a selected number of randomized controlled trials (RCTs) and converted to a
numeric score. After completion, the screening system was validated against all
published RCTs known to us of nutritional support vs spontaneous intake to
investigate whether the screening system could distinguish between trials with a
positive outcome and trials with no effect on outcome.
METHODS: The total number of randomized trials identified was 128. In each trial,
the group of patients was classified with respect to nutritional status and
severity of disease, and it was determined whether the effect of nutritional
intervention on clinical outcome was positive or absent.
RESULTS: Among 75 studies of patients classified as being nutritionally at-risk,
43 showed a positive effect of nutritional support on clinical outcome. Among 53
studies of patients not considered to be nutritionally at-risk, 14 showed a
positive effect (P=0.0006). This corresponded to a likelihood ratio (true
positive/false positive) of 1.7 (95% CI: 2.3-1.2). For 71 studies of parenteral
nutrition, the likelihood ratio was 1.4 (1.9-1.0), and for 56 studies of enteral
or oral nutrition the likelihood ratio was 2.9 (5.9-1.4).
CONCLUSION: The screening system appears to be able to distinguish between trials
with a positive effect vs no effect, and it can therefore probably also identify
patients who are likely to benefit from nutritional support.
DOI: 10.1016/s0261-5614(02)00214-5
PMID: 12765673 [Indexed for MEDLINE]
