Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
Comparative effectiveness of different nutrition assessment tools (MNA, NRS 2002, MUST) in identifying pressure injury risk among patients who had a stroke: A retrospective cohort study.
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Yin Liping, Kong Jingjing, Liu Jia
Аннотация
BACKGROUND: This study aimed to compare effectiveness of the Mini Nutritional Assessment (MNA), Nutritional Risk Screening 2002 (NRS 2002), and Malnutrition Universal Screening Tool (MUST) in identifying pressure injury risk among patients who had a stroke.
METHODS: This retrospective cohort study collected demographic characteristics MNA, NRS 2002, MUST scores, and key nutritional parameters measured within 24 h of admission. High-risk groups are defined as MUST scores ≥1 point, NRS 2002 scores ≥3 points, and MNA scores <17 points. Pressure injury diagnosis adhered to National Pressure Injury Advisory Panel/European Pressure Ulcer Advisory Panel criteria.
RESULTS: A total of 505 patients who had a stroke were included of which 85 developed a pressure injury. There was no difference in age, sex or type of stroke between the two groups. MUST high-risk group had the highest pressure injury incidence (35.1%) and Kappa value (0.350). The NRS 2002 and MNA high-risk group showed pressure injury incidences of 27.1% and 26.2%, with Kappa values of 0.202 and 0.175. Receiver operating characteristic (ROC) curve analysis confirmed MUST had optimal predictive performance (0.877, 95% CI: 0.833-0.921) and specificity (93.6%). The area under the curve (AUC) values for NRS 2002 and MNA were 0.760 (95% CI: 0.703-0.816) and 0.732 (95% CI: 0.679-0.786) with specificities of 66.7% and 64.7%.
CONCLUSION: MUST demonstrates superior predictive performance (highest AUC and specificity) and risk stratification consistency, outperforming the NRS 2002 and MNA. Therefore, MUST appears to be the most useful among the three tools evaluated, but further research is needed to confirm its predictive ability.
METHODS: This retrospective cohort study collected demographic characteristics MNA, NRS 2002, MUST scores, and key nutritional parameters measured within 24 h of admission. High-risk groups are defined as MUST scores ≥1 point, NRS 2002 scores ≥3 points, and MNA scores <17 points. Pressure injury diagnosis adhered to National Pressure Injury Advisory Panel/European Pressure Ulcer Advisory Panel criteria.
RESULTS: A total of 505 patients who had a stroke were included of which 85 developed a pressure injury. There was no difference in age, sex or type of stroke between the two groups. MUST high-risk group had the highest pressure injury incidence (35.1%) and Kappa value (0.350). The NRS 2002 and MNA high-risk group showed pressure injury incidences of 27.1% and 26.2%, with Kappa values of 0.202 and 0.175. Receiver operating characteristic (ROC) curve analysis confirmed MUST had optimal predictive performance (0.877, 95% CI: 0.833-0.921) and specificity (93.6%). The area under the curve (AUC) values for NRS 2002 and MNA were 0.760 (95% CI: 0.703-0.816) and 0.732 (95% CI: 0.679-0.786) with specificities of 66.7% and 64.7%.
CONCLUSION: MUST demonstrates superior predictive performance (highest AUC and specificity) and risk stratification consistency, outperforming the NRS 2002 and MNA. Therefore, MUST appears to be the most useful among the three tools evaluated, but further research is needed to confirm its predictive ability.