Agreement Between Different Nutritional Assessments Tools Used for Elderly Hospitalized Patients

Ihab A. Naser^1*, Ahmed M. Abushabab², Ayman S. Abu Tair¹ and Ihab M. Almasri³

¹Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Al Azhar University –Gaza, Gaza Strip, State of Palestine.

²Nurse at Nasser Medical Complex, MOH – Gaza, State of Palestine.

³Faculty of Pharmacy at Al Azhar University – Gaza, Gaza Strip, State of Palestine.

Corresponding Author Email: ihab.naser@alazhar.edu.ps

Nutrition assessment enables early diagnosis of patients at risk of malnutrition and those who are already malnourished. The main objective of the study was to evaluate the agreement between Mini Nutrition Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) as tools for nutritional assessment against the Subjective Global Assessment (SGA) among elderly hospitalized patients. One hundred and fifty hospitalized elderly patients were enrolled in this cross-sectional study. All elderly hospitalized patients aged 65 years who were admitted into medical and surgical departments and signed the consent form were recruited for the study. Socio-demographic and socioeconomic data, medical and nutritional characteristics, anthropometric measurements, biochemical measurements, SGA, MNA, and GNRI were collected from all respondents. The study was approved by the local Helsinki Committee (PHRC/HC/721/20). According to SGA, MNA, and GNRI results, 52.7%, 20.7%, and 4% of hospitalized elderly patients were suffering from malnutrition, respectively. More than half of the respondents were obese. All measured anthropometric parameters in the malnutrition group in all nutritional assessment tools were significantly lower than the non-malnutrition group. With reference to the SGA; the sensitivity, specificity, PPV, and NPV for the GNRI were 0.075, 1, 1, and 0.493, respectively, while those for the MNA were 0.354, 0.957, 0.903, and 0.571, respectively. The AUC of the GNRI was comparable to that of the MNA (0.711 and 0.860, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI and MNA was 108.919 and 21.75, respectively. Results of this study indicated that elderly patients were suffering from different degrees of malnutrition and unfortunately they are undetected. GNRI and MNA show low sensitivity and NPV. Both the GNRI and MNA have a high Area Under the Curve (AUC), thus enabling the discovery of malnutrition in patients. The newly emerging cutoff points of GNRI and MNA for the Palestinian elderly indicated the highest sensitivity and specificity values than the original cutoff points.

GNRI; Gaza; Hospitalized Elderly; Malnutrition; MNA; SGA

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