PD494 - VALIDATION AND NEED OF MALNUTRITION SCREENING TOOLS IN HOSPITALISED PATIENTS WITH DIABETIC FOOT ULCERS

PD494

VALIDATION AND NEED OF MALNUTRITION SCREENING TOOLS IN HOSPITALISED PATIENTS WITH DIABETIC FOOT ULCERS

T. de Smit¹, E. Vasse¹, I. Teunissen¹, M. Balvers^2,*, J. Kolkert³

¹Department of Dietetics, Gelderse Vallei Hospital, Ede, ²Division of Human Nutrition and Health, Wageningen University, Wageningen, ³Department of Surgery, Gelderse Vallei Hospital, Ede, Netherlands

Rationale: Malnutrition is common in hospitalised patients with diabetic foot ulcers (DFUs) and adversely affects clinical outcomes. However, no consensus exists on the most appropriate screening tool for malnutrition in this population. This study compared the performance of four malnutrition screening tools against the Global Leadership Initiative on Malnutrition (GLIM) criteria and the Mini Nutritional Assessment Full Form (MNA-FF) in hospitalised DFU patients.

Methods: Hospitalised DFU patients (≥18 years) were included. GLIM criteria, MNA-FF, the Short Nutritional Assessment Questionnaire (SNAQ), CONtrolling NUTritional status (CONUT), the Geriatric Nutritional Risk Index (GNRI), and the Mini Nutritional Assessment Short Form (MNA-SF) were assessed in each patient. Sensitivity, specificity, positive predictive value and negative predictive value were detemined for SNAQ, CONUT, GNRI and MNA-SF by comparing their dichotomized output against the GLIM criteria and MNA-FF as reference methods. 

Results: 75 patients were included (81% male). Malnutrition prevalence was 46% and 32%, according to GLIM and MNA-FF, respectively. SNAQ showed the highest sensitivity and specificity of > 70%. GNRI showed comparable sensitivity but lower specificity of 58%. CONUT and MNA-SF showed higher sensitivity but lower specificity of 9% and 21%, respectively.

Conclusion: SNAQ demonstrated best overall validity compared with GLIM and MNA-FF in hospitalised DFU patients, though it failed to detect all patients at risk of malnutrition. Tool choice strongly affects identification of patients at risk of malnutrition. Given the complexity of malnutrition in DFU and the absence of a reference method for malnutrition risk, greater emphasis on early detection and clearer definition of malnutrition risk is needed. Further investigation is needed before the GLIM criteria can be directly applied in this high-risk group.

Disclosure of Interest: None declared