著者

川上 純子 三上 憲子 飛田 美穂 倉田 康久 兵藤 透

出版者

相模女子大学

雑誌

相模女子大学紀要. B, 自然系 (ISSN:09167676)

巻号頁・発行日

vol.76, pp.1-6, 2012

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Objective : To investigate the limit of validity of assessment of nutritional risk by using serum albumin values, which is handily used for assessing nutrition risk of patients, and explore feasible tools for high risk patients, by comparing index of serum albumin values and other assessment tools : Mini Nutritional Assessment-Short Form (MNA-SF) as a well validated nutrition screening and assessment tool, Barthel Index (BI) as an index of activities of daily living, Karnofsky Performance Scale (KPS) as a tool for assessing patients functional impairment, and Geriatric Nutritional risk Index (GNRI) as based on serum albumin values and the discrepancy between real and ideal weight for the elderly. Subjects : Seventy outpatients at a dialysis institution in Kanagawa prefecture (40 male, 30 female) ; mean age 68.0 ± 10.4 (male 67.9 ± 10.1, female 68.4 ± 11.0). Methods : 1. Examined correlation among outcomes of MNA-SF, BI, KPS, GNRI tools, and also between these outcomes and serum albumin values as an index of Objective Dietary Assessment. 2. Examined outcomes (scores) of MNA-SF methods and GNRI methods with regards to patients of serum albumin values under 3.4 g/dl. Results : (N=70) Correlation between assessment tools; (1) between MNA-SF scores and KPS scores, r=0.4952, p<0.001, (2) between serum albumin values and KPS scores, r=0.3693, p<0.01, (3) between serum albumin values and BI scores, r=0.0819, p=0.5. For patients with albumin values under 3.4 g/dl ; four male : mean albumin value, 3.1± 0.5 g/dl, mean GNRI score, 81.4 ± 6.9 (classified as major risk), five female : mean albumin value, 3.2 ± 0.2 g/dl, mean GNRI score, 89.7 ± 8.2 (classified as moderate risk). Discussion and Conclusion : Based on MNA-SF, which is a well validated nutrition screening and assessment tool, its scores had the higher correlation with KPS scores than the other tool's scores, while weak correlation was found between serum albumin values and KPS scores. It was also found that there was a possibility that BI was not related with serum albumin values. Serum albumin value may be a feasible screening tool of nutritional risk of dialysis outpatients, as it may reflect disease prognosis and severity. However, it alone may not reflect ADL of these patients. Therefore, among these methods, MNA-SF method may have possibility of adequately assessing patients' overall physical condition, while BI method was suggested that it may have possibility for assessing specifically patients' ADL.