Does the MNA-SF compare favorably to the MUST tool for predicting postoperative outcomes in older patients undergoing general surgery?
The MNA-SF tool is more consistently associated with postoperative outcomes, including mortality and length of stay, than the MUST tool in older patients undergoing general surgery.
The optimal malnutrition screening tool in geriatric surgery has yet to be determined. Herein, we compare two main tools in older patients undergoing general surgery operations. Older patients (>65 years old) who underwent general surgery operations between 2012 and 2017 in a tertiary centre were included. The Malnutrition Universal Screening Tool (MUST) and the Mini Nutritional Assessment Short Form (MNA-SF) were used for nutritional risk assessment. Preoperative variables as well as postoperative outcomes were recorded prospectively. Agreement between tools was determined with the weighted kappa (κ) statistic. Multiple regression analysis was used to assess the association of the screening tools with postoperative outcomes. A total of 302 patients (median age 74 years, range: 65–92) were included. A similar number of patients were classified as medium/high risk for malnutrition with the MNA-SF and MUST (26% vs. 36%, p = 0.126). Agreement between the two tools was moderate (weighted κ: 0.474; 95%CI: 0.381–0.568). In the multivariate analysis, MNA-SF was associated significantly with postoperative mortality (p = 0.038) and with postoperative length of stay (p = 0.001). MUST was associated with postoperative length of stay (p = 0.048). The MNA-SF seems to be more consistently associated with postoperative outcomes in elderly patients undergoing general surgery compared with the MUST tool.
Kokkinakis et al. (Tue,) studied this question.