Abstract：
Individuals receiving hemodialysis are at increased risk of malnutrition; however, regular diagnosis of malnutrition using subjective global assessment (SGA) is time-consuming. This study aimed to determine whether the Canadian Nutrition Screening Tool (CNST) or the Geriatric Nutrition Risk Index (GNRI) screening tools could accurately identify hemodialysis patients at risk for malnutrition. A retrospective medical chart review was conducted for in-centre day shift hemodialysis patients (n = 95) to obtain the results of the SGA assessment and the CNST screener and to calculate the GNRI score. Sensitivity and specificity analyses showed only a fair agreement between the SGA and CNST (sensitivity = 20%; specificity 96%; κ = .210 (95% CI, -0.015 to .435), p < .05) and between the SGA and GNRI (sensitivity = 35%; specificity = 88%; κ = .248 (95% CI, .017 to .479), p < .05). There was no significant statistical difference between the accuracy of either tool in identifying patients at risk of malnutrition (p = .50). The CNST and GNRI do not accurately screen for risk of malnutrition in the hemodialysis population; therefore, further studies are needed to determine an effective malnutrition screening tool in this population.
摘要：
接受血液透析的人营养不良的风险增加；然而，使用主观整体评估（SGA）定期诊断营养不良是耗时的。这项研究旨在确定加拿大营养筛查工具（CNST）或老年营养风险指数（GNRI）筛查工具是否可以准确识别有营养不良风险的血液透析患者。对中心日班血液透析患者（n=95）进行了回顾性医学图表审查，以获得SGA评估和CNST筛选器的结果，并计算GNRI评分。敏感性和特异性分析显示，SGA和CNST之间仅有相当的一致性（敏感性=20％；特异性96％；κ=.210（95％CI，-0.015至.435），p<.05）以及SGA和GNRI之间（灵敏度=35％；特异性=88％；κ=.248（95％CI，.017至.479），p<.05)。两种工具在识别有营养不良风险的患者的准确性之间没有显着统计学差异（p=.50）。CNST和GNRI无法准确筛查血液透析人群中营养不良的风险；因此，需要进一步的研究来确定该人群中有效的营养不良筛查工具.
