Predictive Value of Nutritional Risk Screening 2002 and Mini Nutritional Assessment Short Form in Mortality in Chinese Hospitalized Geriatric Patients

Figures & data

Table 1 Comparison of Basic Baseline Anthropometric and Biochemical Characteristics of Subjects According to NRS2002 and MNA-SF Assessment

Variables	NRS		P	MNA-SF		P
	Malnutrition/Nutritional Risk	Normal		Malnutrition/Nutritional Risk	Normal
Case(%)	161(30.04)	375(69.96)	/	284(52.99)	252(47.01)	/
Age(year)	87.64±4.33	86.49±4.15	0.004	87.81±4.33	85.75±3.85	<0.001
Sex(M/F)	117/44	289/86	0.164	205/79	201/51	0.167
BMI(kg/m^2)	22.64±3.53	24.08±3.69	0.002	22.48±3.98	24.72±3.17	<0.001
MAC(cm)	22.79±3.27	26.62±6.57	0.011	23.90±7.23	27.17±7.15	0.010
WC(cm)	84.80±11.95	88.77±18.37	0.111	86.44±14.87	88.98±18.75	0.228
CC(cm)	28.52±4.41	31.18±4.14	<0.001	28.92±4.56	31.84±3.72	<0.001
HGS(kg)	17.12±6.36	20.41±17.66	0.006	17.47±7.28	21.23±7.11	<0.001
TLC(cells/m^3)	1.20(0.90–1.70)	1.40(1.10–1.80)	0.393	1.30(1.00–1.70)	1.40(1.10–1.80)	0.195
ALB (g/dl)	37.27±5.04	39.61±4.04	<0.001	37.48±4.69	40.55±3.61	<0.001
PAB(mg/L)	189.77±64.63	205.34±49.51	0.008	191.79±56.96	210.73±50.85	<0.001
Hb (g/dL)	110.31±19.96	120.76±17.66	<0.001	112.81±19.72	123.12±16.49	<0.001
RBP(mg/L)	40.46±9.86	43.31±8.62	0.002	41.20±9.34	43.86±8.63	0.001
Cr (μmol/L)	75.50(60.75–96.25)	84.00(69.00–100.00)	0.474	79.00(61.25–99.75)	84.00(70.00–99.00)	0.323
Iron(μmol/L)	8.43±4.77	13.51±5.58	<0.001	10.07±4.76	14.72±5.63	<0.001
Transferrin(μmol/L)	1.62±0.59	2.02±0.36	0.008	1.79±0.50	2.07±0.32	0.016
Folic acid(μg/L)	7.57(5.06–13.44)	7.79(5.16–12.24)	0.742	7.09(4.76–11.28)	8.51(5.60–12.69)	0.110
Vitamin B12(ng/L)	737.00(435.43–1092.50)	656.15(483.38–944.03)	0.370	649.00(438.00–970.60)	662.90(485.85–919.30)	0.990
CRP (mg/L)	9.77(4.54–16.03)	3.63(1.01–6.25)	0.007	9.00(3.42–17.16)	2.08(0.67–7.26)	<0.001

Abbreviations: BMI, body mass index; MAC, mid-arm circumference; WC, waist circumference; CC, calf circumference; HGS, handgrip strength; TCL, total lymphocyte count; ALB, albumin; PAB, prealbumin; Hb, hemoglobin; RBP, retinol-binding protein; Cr, creatine; CRP, C reactive protein.

Table 2 Correlation of Anthropometric and Biochemical Parameters with NRS2002 and MNA-SF Scores

Variable	NRS		MNA-SF
	r	P	r	P
Age	0.154	<0.001	−0.252	<0.001
Sex	−0.062	0.150	0.090	0.056
BMI	−0.087	0.089	0.349	<0.001
MAC	−0.211	<0.001	0.352	<0.001
WC	−0.204	<0.001	0.250	<0.001
CC	−0.314	<0.001	0.449	<0.001
HGS	−0.213	0.001	0.314	<0.001
TLC	−0.094	0.035	0.089	0.046
ALB	−0.278	<0.001	0.422	<0.001
PAB	−0.192	<0.001	0.229	<0.001
Hb	−0.284	<0.001	0.345	<0.001
RBP	−0.174	<0.001	0.209	<0.001
Cr	−0.066	0.135	0.135	0.002
Iron	−0.397	<0.001	0.422	<0.001
Transferrin	−0.025	0.833	0.282	0.014
Folic acid	0.009	0.905	0.118	0.105
Vitamin B12	0.069	0.337	−0.013	0.851
CRP	0.327	<0.001	−0.375	<0.001

Table 3 Kappa Test for Agreement in Diagnosing Malnutrition/Nutritional Risk Between NRS2002 and MNA-SF Scores (n=536)

	MNA-SF	Malnutrition/Nutritional Risk	Total
	Normal
NRS2002
Normal	244	131	375
Malnutrition/nutritional risk	8	153	161
Total	252	284	536
κ (95% CI)	0.493(0.460–0.526)
P	<0.001

Table 4 Comparison of the Characteristics of the Agreement and Disagreement Patients According to NRS2002 and MNA-SF Assessment

Variables	Agreement	Only MNA-SF	P
Case(n)	153	131	/
Age(year)	87.69±4.30	87.95±4.38	0.623
Sex(M/F)	112/41	93/38	0.192
BMI(kg/m^2)	22.46±3.59	22.49±4.29	0.965
MAC(cm)	22.62±3.30	25.09±9.42	0.064
WC(cm)	88.26±16.90	84.50±12.18	0.171
CC(cm)	28.20±4.38	29.60±4.66	0.096
HGS(kg)	17.17±6.43	17.71±7.96	0.704
TLC(cells/m^3)	1.20(0.90–1.60)	1.30(1.00–1.80)	0.129
ALB(g/dl)	37.00±4.94	38.04±4.35	0.065
PAB(mg/L)	188.14±64.16	196.14±46.83	0.248
Hb (g/dL)	109.86±20.13	116.21±18.75	0.008
RBP(mg/L)	40.34±9.93	42.22±8.49	0.099
Cr (μmol/L)	75.50(59.00–97.50)	83.50(66.75–105.00)	0.062
Iron(μmol/L)	8.43±4.77	10.96±4.57	0.040
Transferrin(μmol/L)	1.56±0.61	1.88±0.44	0.154
Folic acid(μg/L)	7.01(5.05–13.01)	7.20(4.67)	0.672
Vitamin B12(ng/L)	737.00(435.43–1092.50)	644.60(460.75–945.65)	0.264
CRP (mg/L)	9.83(4.58–16.47)	5.59(2.92–14.58)	0.060
Survive days	319.50(87.50–513.25)	421.00(82.00–672.00)	0.072

Notes: Agreement: Both NRS2002 and MNA-SF assessed were malnutrition/nutritional risk. Only MNA-SF: according to MNA-SF assessed classified as malnutrition/nutritional risk but not NRS2002.

Figure 1 Kaplan–Meier analysis for mortality. (A) Malnutrition/nutritional risk vs normal according to NRS2002 assessment, Log rank test χ²=17.67, P<0.001. (B) Malnutrition/nutritional risk vs normal according to MNA-SF assessment, Log rank test χ²=28.999, P<0.001.

Table 5 Cox Proportional Hazard Regression Analysis of Mortality

Variables	Univariate		Multivariate
	HR (95% CI)	P	HR (95% CI)	P
Age	1.112(1.066–1.116)	<0.001	1.002(0.878–1.143)	0.976
MAC	0.906(0.825–0.996)	0.041	0.829(0.572–1.201)	0.321
CC	0.880(0.840–0.923)	<0.001	0.915(0.700–1.196)	0.517
HGS	0.928(0.891–0.967)	<0.001	0.956(0.848–1.077)	0.459
Hb	0.971(0.962–0.980)	<0.001	0.993(0.957–1.029)	0.689
ALB	0.873(0.841–0.905)	<0.001	0.912(0.796–1.045)	0.186
PAB	0.994(0.990–0.998)	0.001	1.003(0.991–1.015)	0.663
Cr	1.003(1.002–1.005)	<0.001	1.012(0.999–1.024)	0.074
Iron	0.864(0.796–0.938)	<0.001	1.040(0.898–1.205)	0.596
NRS2002	1.528(1.329–1.757)	<0.001	3.657(1.447–9.240)	0.006
MNA-SF	0.833(0.788–0.880)	<0.001	1.200(0.829–1.738)	0.334