Predictors of Nutritional Risk According to NRS-2002 and Calf Circumference in Hospitalized Older Adults with Neoplasms

ABSTRACT

Objectives: To investigate nutritional markers that better predict nutritional risk according to the Nutritional Risk Screening (NRS-2002), to verify agreement between indicators, and to identify the calf circumference cut-off point for diagnosing nutritional risk.

Methods: Cross-sectional study with older patients hospitalized for neoplasms. The nutritional risk was assessed by NRS-2002 and the nutritional status by Subjective Global Assessment (SGA), Mini-Nutritional Assessment (MNA long form), calf circumference (CC), and body mass index (BMI). Statistical analyses included the chi-square and Mann–Whitney tests, Kappa coefficient, univariate and multiple logistic regression analyses to analyze the risk factors, and the receiver operator characteristic (ROC) curve to determine the cut-off point.

Results: The NRS-2002 and MNA had good agreement (k = 0.5281), but the NRS-2002 did not agree with the other nutritional indicators. According to regression analysis, the predictors of nutritional risk were the MNA (p = 0.0010, OR = 28.270); BMI (p = 0.0419, OR = 4.681), and age (p = 0.0021, OR = 1.309). The best CC cut-off point for predicting nutritional risk according to the NRS-2002 was ≤32.25 cm.

Conclusion: Both the NRS-2002 and MNA are useful for the nutritional diagnosis of older adults hospitalized for neoplasms. When the MNA, BMI, and age are used together, they can better predict nutritional risk according to the NRS-2002.

Acknowledgments

The authors thank the Hospital and Maternity Hospital Celso Pierro and the Pontifical Catholic University of Campinas (Puc-Campinas)-SP-Brazil, for their support and the opportunity to conduct this study.

Conflicts of Interest

The authors report no conflicts of interest.

Authors' Contributions

All authors contributed to study conception, data analysis and interpretation, and manuscript writing. All authors approved the final version of the manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

This project was not funded.