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Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults†

Published online by Cambridge University Press:  09 March 2007

Rebecca J. Stratton ,
Annemarie Hackston ,
David Longmore ,
Rod Dixon ,
Sarah Price ,
Mike Stroud ,
Claire King  and
Marinos Elia
Rebecca J. Stratton*
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
Annemarie Hackston
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
David Longmore
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
Rod Dixon
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
Sarah Price
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
Mike Stroud
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
Claire King
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
Marinos Elia
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southampton, UK
*
*Corresponding author: Dr Rebecca J. Stratton, fax +44 23 80794945, email, R.J.Stratton@soton.ac.uk
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Abstract

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The ‘malnutrition universal screening tool’ (‘MUST’) for adults has been developed for all health care settings and patient groups, but ease of use and agreement with other published tools when screening to identify malnutrition requires investigation. The present study assessed the agreement and the prevalence of malnutrition risk between ‘MUST’ and a variety of other tools in the same patients and compared the ease of using these tools. Groups of patients were consecutively screened using ‘MUST’ and: (1) MEREC Bulletin (MEREC) and Hickson and Hill (HH) tools (fifty gastroenterology outpatients); (2) nutrition risk score (NRS) and malnutrition screening tool (MST; seventy-five medical inpatients); (3) short-form mini nutritional assessment (MNA-tool; eighty-six elderly and eighty-five surgical inpatients); (4) subjective global assessment (SGA; fifty medical inpatients); (5) Doyle undernutrition risk score (URS; fifty-two surgical inpatients). Using ‘MUST’, the prevalence of malnutrition risk ranged from 19–60% in inpatients and 30% in outpatients. ‘MUST’ had ‘excellent’ agreement (κ 0.775–0.893) with MEREC, NRS and SGA tools, ‘fair–good’ agreement (κ 0.551–0.711) with HH, MST and MNA-tool tools and ‘poor’ agreement with the URS tool (κ 0.255). When categorisation of malnutrition risk differed between tools, it did not do so systematically, except between ‘MUST’ and MNA-tool (P=0.0005) and URS (P=0.039). ‘MUST’ and MST were the easiest, quickest tools to complete (3–5 min). The present investigation suggested a high prevalence of malnutrition in hospital inpatients and outpatients (19–60% with ‘MUST’) and ‘fair–good’ to ‘excellent’ agreement beyond chance between ‘MUST’ and most other tools studied. ‘MUST’ was quick and easy to use in these patient groups.

Keywords

MalnutritionScreeningValidityAdults
Type
Research Article
Information
British Journal of Nutrition , Volume 92 , Issue 5 , November 2004 , pp. 799 - 808
Copyright
Copyright © The Nutrition Society 2004

Footnotes

†

Some of the results have been presented as abstracts at meetings of the British Association for Parenteral and Enteral Nutrition (BAPEN) and the European Society of Parenteral and Enteral Nutrition (ESPEN). For more information and for a free download of the malnutrition universal screening tool and the explanatory booklet, see www.bapen.org.uk

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