Table 1 Nutritional risk screening scale (NRS-2002)
Initial screning | |||
1 | Is Bmi <20.5? | Yes | No |
2 | Has the patient lost weight within the last 3 months? | ||
3 | Has the patient had a reduced dietary intake in the last week? | ||
4 | Is the patient severed ill? (e.g. in intensive therapy) | ||
Yes: if the answer is ‘Yes’ to any question, the screening in Table 2 is performed. No: if the answer is ‘No’ to all question, the patient is rescreened at weekly intervals. If the patient e.g. is schedule for a major operation, a preventive nutritional care plan is considered to avoid the associated risk status. | |||
Final screening | |||
Impaired nutritional status | Severity of disease (≈ increase in requirement) | ||
Absent Score 0 | Normal nutritional status | Absent Score 0 | Normal nutritional requirements |
Mild Score 1 | Wt loss >5 % in 3 mths or Food intake below 50–75 % of normal requirement in preceing week | Mild Score 1 | Hip fractured, Chronic patients, in particular with acute complications: cirrhosis, COPD. Chronic hemodialysis, diabetes, oncology |
Moderate Score 2 | Wt loss >5 % in 1 mth (>15 % in 3 mths) or BMI 18.5-20.5 + impaired general condition or Food intake 25-60 % of normal requirement in preceding week | Moderate Score 2 | Major abdominal surgery, Stroke Severe pnemonia, hematologic maligancy |
Severe Score 3 | Wt loss >5 % in 1 mth (>15 % in 3 mths) or BMI <18.5+ impaired general condition or Food intake 0-25 % of normal requirement in preceding week in preceding week. | Severe Score 3 | Head injury, Bone marrow transplantation. Intensive care patients (APACHE >10). |
Score | + | Score | -Total |
Age | if ≥70 years: add 1 to total score above | - age-adjusted total score | |
Score ≥3: the patient is nutritionally at-risk and a nutritional care plan is initiated; Score <3: weekly rescreening of the patient. If the patient e.g. is schedule for a major operation, a preventive nutritional care plan is considered to avoid the associated risk status. | |||