Concurrent and predictive validity of the Mini Nutritional Assessment Short‐Form and the Geriatric Nutritional Risk Index in older stroke rehabilitation patients

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Bibliographic Information

Title
Concurrent and predictive validity of the Mini Nutritional Assessment Short‐Form and the Geriatric Nutritional Risk Index in older stroke rehabilitation patients
Other Title
  • 高齢脳卒中リハビリテーション患者におけるMini Nutritional Assessment Short-FormとGeriatric Nutritional Risk Indexの併存的および予測的妥当性
Author
Nishioka, Shinta
Alias Name
  • 西岡, 心大
  • ニシオカ, シンタ
Author
Omagari, Katsuhisa
Alias Name
  • オオマガリ, カツヒサ
  • オオマガリ, カツヒサ
Author
Nishioka, Emi
Alias Name
  • ニシオカ, エミ
  • ニシオカ, エミ
Author
Mori, Natsumi
Alias Name
  • モリ, ナツミ
  • モリ, ナツミ
Author
竹谷, 豊
Author
Kayashita, Jun
Alias Name
  • カヤシタ, ジュン
  • カヤシタ, ジュン
University
徳島大学
Types of degree
博士（栄養学）
Grant ID
甲栄第279号
Degree year
2019-08-21

Description

Background: Malnutrition might worsen the clinical outcomes in stroke patients, although few nutritional screening tools have assessed their validity. Methods: We assessed clinical data of consecutive stroke patients aged ≥65 years in rehabilitation hospital from 2015 to 2017 using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Geriatric Nutritional Risk Index (GNRI) for index testing. The European Society for Parenteral and Enteral Nutrition diagnostic criteria for malnutrition (ESPEN-DCM) was used as a reference standard. The receiver-operating characteristics curve was illustrated by the sensitivity (Se) and specificity (Sp). The Youden index was used to define the cut-off value for malnutrition detection or screening. The Functional Independence Measure (FIM) and discharge destination were compared for verifying predictive validity. Results: We enrolled 420 patients for the analysis. Of them, 125 patients were included in malnutrition group (mean age: 80 years) and 295 in non-malnutrition group (mean age: 77 years) by the ESPEN-DCM. The area under the curve of the MNA-SF and the GNRI were 0.890 and 0.865, respectively. Se and Sp cut-off values to detect or screen malnutrition were 5 (Se: 0.78; Sp: 0.85) and 7 (Se: 0.96; Sp: 0.57) for the MNA-SF and 92 (Se: 0.74; Sp: 0.84) and 98 (Se: 0.93; Sp: 0.50) for the GNRI, respectively. The GNRI were associated with discharge destination, whereas no correlation was observed between the MNA-SF and outcomes by multivariable analysis. Conclusions: The MNA-SF and GNRI have fair concurrent validity if appropriate cut-off values were used. The GNRI exhibits good predictive validity in stroke patients.

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