Article

A disease-specific nutrition screening tool (NST): the
spinal nutrition screening tool (SNST) has been developed for use in patients
with spinal cord injury (SCI) but its reliability and agreement with other
published tools requires investigation. The aims of this study were to assess the
prevalence of malnutrition risk in SCI patients and to confirm the diagnostic
accuracy of the SNST. METHODS: Patients' baseline clinical data,
anthropometric measurements and NST scores were assessed. The validity of the
SNST was assessed by (i) comparing with a full dietetic assessment (criterion
validity); (ii) comparison with a generic NST: malnutrition universal screening
tool (MUST) (concurrent validity); and (iii) completion of an additional SNST to
assess inter- and intra-rater reliability. Agreement was assessed using Cohen's
kappa-statistics. RESULTS: Using the SNST, the prevalence of malnutrition risk
ranged from 22 to 64% on admission to four SCI centres. The SNST had substantial
agreement with MUST (kappa: 0.723, 95% confidence interval (CI): 0.607-0.839) and
dietitian assessment (kappa: 0.567, 95% CI: 0.434-0.699). The SNST had a moderate
to substantial reliability (inter-rater reliability: kappa: 0.5, 95% CI: 0.2-0.8;
intra-rater reliability: kappa: 0.64, 95% CI: 0.486-0.802). When compared with
dietetic assessment, the SNST had a numerically lower specificity (76.1% vs
80.4%) and similar agreement to MUST (kappa: 0.57 vs 0.58) but SNST showed a
numerically higher sensitivity (85.7% vs 80.4%) and a numerically higher negative
predictive value (92% vs 89.2%) than MUST. CONCLUSIONS:
This study shows that
malnutrition is common in SCI patients. The SNST is an acceptable (valid and
reliable) NST and may be a useful alternative to MUST in identifying SCI patients
at risk of malnutrition.

Langue : ANGLAIS

Tiré à part : OUI