Tool | Element | Forms of assessment | Efficiency assessment |
---|---|---|---|
NRS-2002 | Impaired nutritional status (weight loss, BMI, and food intake) and disease severity | Marking Scheme | Very effective |
MUST | BMI, weight loss in the past 3–6 months, and acute illness of >5 days duration | Marking Scheme | Very effective |
NMA | BMI, recent weight loss status, diet, nutrient absorption status, physical health status | Marking Scheme | Effective |
SGA | Medical history (weight change, dietary intake, gastrointestinal symptoms, functional capacity, and metabolic stress) and physical examination (subcutaneous fat loss, muscle wasting, edema, and ascites). | Questionnaire | Effective |
PG-SGA | Subjective patient assessment: weight, food intake, symptoms, activities, and body functions + Medical staff assessment: relationship between disease and nutritional needs, metabolic needs, physical examination | Questionnaire | Effective |
PNI | 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (cells/mm3) | Formula | Simple and fast, but requires lab parameters |
NRI | 1.489 × serum albumin (g/L) + 41.7 × (current weight/usual weight) | Formula | Simple and fast, but requires lab parameters |
NRS | Unintentional weight loss in the past 3 months, BMI, appetite, ability to eat or retain food, and severity of disease | Marking Scheme | Very effective |
COUNT | Serum albumin level (Ag/dL), total lymphocyte count (n/mm3), total cholesterol concentration (mg/dL) | Marking Scheme | Simple and fast, but requires lab parameters |
Nutritional support pathway and indication | Contraindication |
---|---|
Preoperative and postoperative supportive care for malnourished patients | Complete mechanical intestinal obstruction, paralytic intestinal obstruction |
Difficulty in swallowing or chewing | Gastrointestinal bleeding and perforation |
Disorders of consciousness and coma | Abdominal or intestinal infection |
Stable stage of digestive tract disease | Early stage and shock state of severe infection, trauma and other stress states |
High catabolic state | Early stage of short bowel syndrome, high flow intestinal fistula |
chronic wasting disease | Severe vomiting, diarrhea, malabsorption |
Mechanical obstruction and paralytic intestinal obstruction caused by EN | Patients with normal gastrointestinal function or indications for EN |
Short bowel syndrome | Cardiovascular dysfunction or severe metabolic disorder |
Absorptive dysfunction | High intestinal fistula, congenital malformation of gastrointestinal tract, and excessive gastrointestinal reaction during radiotherapy |
Severe vomiting and diarrhea | Severe burns and severe infections |
Severe malnutrition | Ulcerative colitis, localized enteritis, long-term diarrhea |
Hyperemesis gravidarum | Necrotizing pancreatitis, acute renal failure, liver failure |
High risk of aspiration | Brain death or irreversible coma |