• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권2호
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• pp.95-103
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• 2013

Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.

• 대한암한의학회지
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• 제24권2호
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• pp.1-11
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• 2019

Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

• 대한지역사회영양학회지
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• 제11권6호
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• pp.779-784
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• 2006

Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.473-480
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• 2022

Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

• Journal of Nutrition and Health
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• 제33권8호
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• pp.864-872
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• 2000

This study intended to evaluate the validity of the simple nutrition screening test that had been developed with the elderly living in Cheongju as a subject. Nutrition screening score(NSS) and reference standards for nutritional and health status(nutrient intakes, mean adequacy ratio, perceive health, and serum albumin, hematocrit, and hemoglobin) were estimated by using the date obtained in 1996 from the 174 elderly living in Taejon, Statistical analysis showed significant correlations between mean adequacy ratio(MAR) and NSS(r=0.341) and also between NSS and biological indices such as albumin and hematocrit, Around 65-75% of the elderly with perceive health and low level of serum albumin, hemoglobin and hematocrit had NSS$\leq$ll. Sensitivity, specificity, and positive predictive values(PPV) were calculated from the crosstabulation of the three categories of NSS(high, moderate, and low nutritional risk) and low categories MAR(< 0.75, undernutrition;$\geq$0.75, normal) to validate the cut-off point for high or low nutritional risk by NSS. It was suggested that point l1 was appropriate as a criterion to determine high risk of undernutrition, but point 16 was better than 17 as criterion to determine low nutritional risk in the Taejon elderly. When point ll was used as a criterion of high nutritional risk, sensitivity, specificity, and PPV are 59.5, 60.5 and 82.1 respectively. When point 16 was used as a criterion of low nutritional risk, sensitivity, specificity, and PPV are 25.6, 95.4, and 64.7%, respectively. In conclusion, nutrition screening test that had been developed can be a simple, easy, and proper instrument to classify the high risk group of undernutrition. A further validation study seems to be required among other groups of individuals for the screening test to the finalized as a more valid instrument identifying Korean elderly at nutrition and health risk(Korean J Nutrition 33(8) : 864-872, 2000)

• Nutrition Research and Practice
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• 제13권5호
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• pp.410-414
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• 2019

BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

• 대한지역사회영양학회지
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• 제5권3호
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• pp.475-483
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• 2000

The develop a simple screening test for identifying Korean elderly at risk of undernutrition, the data of the health-related habits, dietary behaviors and nutrient intakes of the elderly in Chongju were analyzed. Two risk indicators, mean adequacy ratio (MAR) and the respondents perceived health, were used to detect the undernutrition risk of the elderly. In order to select a list of questions for the test, factors a affecting nutritional status and items investigated in previous nutrition surveys of the elderly were considered, and 21 questions were primarily selected. A multiple regression and stepwise regression analysis were used to take out the weak predictors of poor nutrient intake, and to give item weights to the strong predictors, and a list of 17 questions was finally adopted. To determine the cut-point of the test score, sensitivity, and positive predictive values were calculated. The Simple Screening Test developed in this study is a brief, easily scored tool to predict poor nutrient intake and the perceived health status of the elderly. The test may provide a basis of further comprehensive nutritional assessment or intervention planning, if necessary, for those who are diagnosed ad "high risk". The test, however, needs to be independently validated by other groups of individuals.dividuals.

• 대한영양사협회학술지
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• 제16권2호
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• pp.122-132
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• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• 대한지역사회영양학회지
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• 제14권3호
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• pp.340-353
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• 2009

It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

• 대한지역사회영양학회지
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• 제5권1호
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• pp.3-12
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• 2000

The nutritional and health status of low-income alone-living elderly(ALE) was assessed in relation to the activity of daily living (ADL) and nutritional risk factors. One hundred and eighty five ALE over 65 years old, living in the Sungnam area, were interviewed in their homes through questionnaires. The results were as follows : 63.6% of the subjects considered themselves in poor the health and only 4.3% of them considered thermselves healthy. 89.7% of the subjects answered that they were suffering from illness and 29.7% were taking medication. The ADL was assessed through 10 checklist items and the average score of the ADL was $84.78{\pm}11.11$(maximum :100) The nutritional risk index(NRI) was evaluated by 12 risk factors and the average score of the NRI was $4.43{\pm}1.38$ (maximumː12) The scores of the ADL were positively correlated with the scored of the instrumental activities of daily living (IADL)(r=0.7523, p<0.001) and negatively correlated with NRI(r= -0.2694, p<0.001) When subjects were divided into nutritionally high risk group(HNARI: TEX>$NRI{\geq}5$) and nutritionally low risk group(LNRI : NRI<5) according to the USA screening basis, 48.9% of the subjects belonged to the HNRI, But 16.9% of the HNRI and 34.4% of the LNRI belonged to the fourth quartile($Q_{0.75}$) of the ADL, the distribution of which showed significant differences(p<0.05) We suggest that the application of the ADL as a screening tool for nutrition intervention programs for the elderly. Oncemore, further research is needed to develop appropriate checklist items for the ADL and NRI along with the screening basis for the NRI 새 diagnose the adverse nutritional status of the Korean elderly.