Kondrup et al reported the NRS 2002 in light of the ESPEN guidelines of 2002 for nutritional screening. The authors are from an Ad Hoc ESPEN working group and Rigshospitalet in Copenhagen.
Initial screen - one or more of the following:
(1) body mass index < 20.5 kg per square meter
(2) patient has lost weight during the past 3 months
(3) reduced dietary intake over the past week
(4) severely ill
Further assessment:
(1) impaired nutritional status
(2) severity of disease (with increased nutritional requirements)
(3) age
|
Parameter |
Finding |
Points |
|
impaired nutritional status |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
severity of disease |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
age |
< 70 years |
0 |
|
|
>= 70 years |
1 |
|
Impaired Nutrition |
Criteria |
|
mild |
weight loss > 5% over 3 months; food intake in past week less than 50-75% of normal requirements |
|
moderate |
weight loss > 5% over 2 months; BMI 18.5 to 20.5 plus impaired general condition; food intake in past week less ta 25-60% of normal requirements |
|
severe |
weight loss > 5% in last month (> 15% in 3 months); BMI < 18.5 plus impaired general condition; food intake in past week less than 25% of normal requirements |
|
Severity of Disease |
Examples |
|
mild |
hip fracture, cirrhosis, COPD, chronic hemodialysis, diabetes, oncology |
|
moderate |
severe pneumonia, hematologic malignancy |
|
severe |
head injury, bone marrow transplant, ICU with APACHE2 > 10 |
score for nutritional status and disease severity =
= SUM(points for nutritional status and disease severity)
age adjusted total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum scores: 0
• maximum score for nutritional status and disease severity: 6
• maximum score for age adjusted total score: 7
• If the score is >= 3 then the patient is nutritionally at-risk and a nutritional care plan should be started.
• If the score is < 3 then the patient should be screened weekly. If major surgery is planned then a nutritional care plan to prevent a deterioration in nutritional status should be started.
Purpose: To screen a patient for nutritional risk using the NRS 2002.
Specialty: Nutrition
Objective: risk factors
ICD-10: E40-E46, E50-E64,
