Concurrent and Predictive Validity of AND-ASPEN Malnutrition Consensus is Satisfactory in Hospitalized Patients: A longitudinal Study.

BACKGROUND Subjective Global Assessment (SGA) is the reference method to identify hospital malnutrition. The Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition (AND-ASPEN) proposed a more objective consensus to identify malnutrition related to etiology. Studies regarding validity of this consensus are still scarce. This study aimed to evaluate the concurrent and predictive validity of AND-ASPEN Consensus. METHODS Prospective cohort conducted with hospitalized adult and elderly patients. In admission, general data were collected and patients were evaluated by SGA and AND-ASPEN with and without handgrip strength (HGS) for nutritional diagnoses. Patients were followed up for collection of outcomes - length of hospital stay (LOS), in-hospital death, readmission, and mortality in six months after being discharged. Concurrent and predictive validity were tested. RESULTS A total of 600 patients (55.7±14.8 years, 51.3% males) were evaluated. The median of LOS was 10.0 (5.0-18.0) days and in-hospital mortality was 2.7%. SGA identified 34.0% and AND-ASPEN 34.6% of patients as malnourished. AND-ASPEN had substantial agreement with SGA (kappa = 0.690), and satisfactory accuracy (AUC = 0.85; CI 95%, 0.81-0.88). Malnutrition by AND-ASPEN predicted about 1.4 times higher risk of prolonged LOS (CI 95%, 1.2-1.6) and hospital readmission (CI 95%, 1.2-1.8), besides 5.0 times higher risk of hospital death (CI 95%, 1.3-18.8) and six-months death (CI 95%, 2.6-9.9), in an adjusted analysis. The validity of AND-ASPEN without HGS was also satisfactory. CONCLUSION AND-ASPEN can be used for malnutrition diagnoses, even when HGS is not available, since it has satisfactory concurrent and predictive validity. This article is protected by copyright. All rights reserved.