Association between nutritional risk and routine clinical laboratory measurements and adverse outcomes: a prospective study in hospitalized patients of wuhan tongji hospital

BACKGROUND/OBJECTIVES: Nutritional risk screening (NRS-2002) and routine clinical laboratory measurements (RCLMs) had been shown to have a predictive value in adverse outcomes in some studies, respectively. This study analyzed the association between NRS-2002 and RCLMs and estimated their prospective value in predicting adverse outcomes. SUBJECTS/METHODS: A total of 916 hospitalized patients were screened on admission with NRS-2002 and Subjective Global Assessment; RCLMs, which include blood test, kidney and liver function and electrolytes, were recorded. Diagnosis, nutritional support, surgery, radiotherapy, chemotherapy, complications, mortality and hospital stay during hospitalization were collected. The X(2)-test, odds ratios with 95% confidence intervals, kappa (k) statistic and regression analyses were conducted. RESULTS: An overall 48.1% of the 916 patients were at nutritional risk on admission. Comparing ‘at risk' with ‘no risk', a significantly higher incidence of abnormality was found not only in nutritional markers but also in other parameters of RCLMs (OR ranged from 1.5 to 3.5). Regression analyses showed that ‘at risk' determined at admission was not a significant predictor of adverse outcomes after adjusting for other confounding factors, although it was a strong predictor in univariate analysis, whereas hypoalbuminemia, low total lymphocyte count, abnormality of hepatic and renal function were predictors after adjusting for confounders. CONCLUSIONS: The findings suggest that NRS-2002 might be a global index of ‘sickness' rather than be only a nutritional screening tool. It being rated once at admission is insufficient and should be repeated for using it as a predictor, whereas RCLMs routinely measured at admission may be able to be used to predict adverse outcomes.