SKRINING GIZI

Etika Ratna Noer

What is Screening?
Penapisan/identifikasi untuk mengetahui orang yg berisiko terjadi masalah gizi atau malnutrisi Tes Skrining sebaiknya bersifat non-invasive, murah dan hasilnya cepat diketahui Cakupan utama skrining :
1. 2. 3. 4. Berat IMT Penurunan BB Selera makan Kondisi medis dimana tjd peningkatan kebutuhan

Skrining vs Assessment
Nutrition Screening Purpose : to quickly identify individuals nutritionally at-risk or who are malnourished Rapid, simple general procedure done at first contact with subject to detect risk of malnutrition, done by nurses, doctors or others Nutrition Assessment Purpose: to identify early signs of malnutrition and prevent it from morbidity and mortality Detailed, more specific in depth evaluation, done by those with nutritional expertise

Start screening ASAP!

MNA Short Form SGA MUST (Malnutrition Universal Screening Tool) Nutrition Risk Screening (NRS,2002 by ESPEN)

 Developed in 1990 Validated for ages 65+ Simple, reliable, non-invasive, & quick Inexpensive Validated in hospital & community setting For screening & assessment

Guigoz et al., Nutr. Rev. 1996;54:S59-65 Vellas B et al., J Am Geriatr Soc 2000;48:1300-1309c Rubenstein LZ et al., J Gerontol 2001;56:M366-M372

Validation of

MNA

Nursing home, hospitalized & free living elderly Sensitivity 96% Specificity 98%

4 sections: Anthropometrics Diet questionnaire Global assessment lifestyle medications mobility Subjective assessment self perception of health & nutrition

MNA score interpretation

maximum score 30 points 24 : 17 - 23.5 : < 17 : normal/well-nourished border line/at risk of malnutrition undernutrition

Guigoz et al., Facts & Res. Gerontol. 1994 (suppl.2):15-70

MUST
Malnutrition Universal Screening Tool
A practical, reliable, validated tool for nutrition screening Allows comparable nutritional screening across different care settings by different health professionals primary care, home, acute care, long term care Identifies individuals who are undernourished or obese Not specific for the elderly, but adults

Malnutrition Universal Screening Tool

( Schematic )

Step 1
BMI

Step 2 Weight loss

Subjective criteria

Step 3 Acute disease score

Step 4
Overall Risk Of Malnutrition 0 Low risk 1 Medium Risk 2 or more High Risk

Step 5
Consider using suggested management guidelines
Reassess risk category as subject moves through care settings

MUST Validity
Malnutrition Universal Screening Tool
Hospitals
predicts Length of stay predicts discharge destination mortality

Community
predicts rates of hospitali admissions predicts rates of GP visits shows that appropriate intervention improves outcome

NRS - Nutrition Risk Screen

Developed in 2003 (Kondrup et al - ESPEN) Used retrospective analysis of RCT (adults)
Nutritional criteria or characteristics Clinical outcome Assumption: Indications for nutrition support are :
the severity of undernutrition the increase in nutritional requirements from the disease

Screen includes measures of current potential undernutrition & disease severity

NRS - Nutrition Risk Screen

Nutrition Screening is NOT the end but just the beginning!

Tugas : Resume Jurnal

NRS 2002 Comparative 5 tools SGA