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
Nishioka, Shinta Nagasaki Rehabilitation Hospital|University of Nagasaki|Tokushima University
Omagari, Katsuhisa University of Nagasaki
Nishioka, Emi Nagasaki Rehabilitation Hospital
Mori, Natsumi Nagasaki Rehabilitation Hospital
Taketani, Yutaka Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Kayashita, Jun Prefectural University of Hiroshima
Thesis or Dissertation
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.
Journal of Human Nutrition and Dietetics
Wiley|The British Dietetic Association
This is the peer reviewed version of the following article: S. Nishioka, K. Omagari, E. Nishioka, N. Mori, Y. Taketani, J. Kayashita. (2020), Concurrent and predictive validity of the Mini Nutritional Assessment Short-Form and the Geriatric Nutritional Risk Index in older stroke rehabilitation patients. Journal of Human Nutrition and Dietetics, 33(1): 12-22, which has been published in final form at https://doi.org/10.1111/jhn.12699. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
|DOI (Published Version)|
|URL ( Publisher's Version )|
k3418_abstract_review.pdf 215 KB
k3418_fulltext.pdf 962 KB
|MEXT report number||
Doctor of Nutritional Science