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

書誌事項

タイトル
Concurrent and predictive validity of the Mini Nutritional Assessment Short‐Form and the Geriatric Nutritional Risk Index in older stroke rehabilitation patients
タイトル別名
  • 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
著者
西岡, 心大
著者別名
  • ニシオカ, シンタ
  • Nishioka, Shinta
著者
オオマガリ, カツヒサ
著者別名
  • Omagari, Katsuhisa
著者
ニシオカ, エミ
著者別名
  • Nishioka, Emi
著者
モリ, ナツミ
著者別名
  • Mori, Natsumi
著者
竹谷, 豊
著者
カヤシタ, ジュン
著者別名
  • Kayashita, Jun
学位授与大学
徳島大学
取得学位
博士(栄養学)
学位授与番号
甲栄第279号
学位授与年月日
2019-08-21

説明

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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