• Swagata Tripathy and J C Mishra.
• Department of Trauma and Emergency Medicine (Critical Care), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
• Indian J Crit Care Med. 2015 Sep 1; 19 (9): 518-22.

ContextFew malnutrition screening tests are validated in the elderly Intensive Care Unit (ICU) patient.AimHaving previously established malnutrition as a cause of higher mortality in this population, we compared two screening tools in elderly patients.Subjects And MethodsFor this prospective study, 111 consecutive patients admitted to the ICU and > 65 years underwent the Malnutrition Universal Screening Tool (MUST), and the Geriatric Nutrition Risk Index (GNRI) screening tests.Statistical AnalysisStandard definition of malnutrition risk was taken as the gold standard to evaluate the sensitivity, specificity and predictive values of the tools. The k statistic was calculated to measure the agreement between the tools. The Shrout classification was used to interpret its values.ResultsThe mean age of the patients screened was 74.7 ± 8.4 (65-97 years). The standard definition, MUST and GNRI identified 52.2%, 65.4%, and 64.9% to be malnourished, respectively. The sensitivity and specificity of the tests were 96.5% computed tomography (CI) (87.9-99.5%) and 72.3% CI (57.5-84.5%) for MUST and 89.5% CI (75.2-96.7%) and 55.0% CI (75.2-96.9%) for GNRI, respectively. Screening was not possible by GNRI and MUST tool in 31% versus 4% of patients, respectively. The agreement between the tools was moderate for Standard-MUST k = 0.65 and MUST-GNRI k = 0.60 and fair for Standard-GNRI k = 0.43.ConclusionsThe risk of malnutrition is high among our patients as identified by all the tools. Both GNRI and MUST showed a high sensitivity with MUST showing a higher specificity and greater applicability.

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