BMI-based Screening Tool Downplays The Risk of Malnutrition, Study Finds

According to a recent study, the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) appears to be a better screening tool for malnutrition risk than the BMI-based Malnutrition Universal Screening Tool (MUST).

BMI-based Screening Tool Downplays The Risk of Malnutrition, Study Finds
Photo: Body Mass Index (BMI) | InStyleHealth


A total of 430 adult patients (mean age 58.416.2 years, 53.0% male) were enrolled in the study at the time of admission to the hospital. A MUST score of 1 or a PG-SGA SF score of 4 indicated a higher risk of malnutrition. Thirty-five percent of participants (n=150) were overweight, whereas twenty-five percent (n=108) were obese.

MUST found that 16 percent of the whole study sample was at risk of malnutrition, with the trend differing substantially by BMI group (p0.001). In particular, all patients with a low BMI (less than 18.5 kg/m2) were at risk (100%); however, the risk was substantially lower in the overweight (5%) and obese (6%) categories.

When tested by PG-SGA SF, 42 percent of individuals were judged to be at risk of malnutrition. The prevalence of such risk differed considerably by BMI (p=0.001), with 91 percent in the low-BMI group and 31 percent and 42 percent in the overweight and obese groups, respectively.

“On hospital admission, increased malnutrition risk is common across the BMI scale, with more than one-third of patients in the overweight or obese category. Only a small proportion of the latter is detected by the currently utilized MUST, according to the study.

“Alternative methods, such as the PG-SGA SF, that are less reliant on BMI should be examined for initial malnutrition screening, and supplementary nutrition assessment is advised to avoid malnutrition from being unreported and mistreated in all patients, regardless of BMI,” they added.

 

Source: Eur J Clin Nutr 2021;75:1398-1406

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