Malnutrition Indicators Which is More Predictive? Nutrition Risk Index (NRI) or Malnutrition Universal Screening Tool (MUST)

Background: Traumatic brain injury (TBI) is a major cause of disability, death and economic cost. Malnutrition is one of the common factors at the time hospital admission and tends to worsen during hospitalization, among TBI.

Methods: This study was conducted in an outpatient neurosurgery clinic at Khoula Hospital (National Trauma Center)–Muscat–Oman. 77 TBI adult patients, aged 18-65 years, males and females were included in this study. Patients were invited to participate in an anonymous survey. This invitation was extended during routine outpatient visits.

Results: The majority of patients were males (85.9%) with 6.1:1 male to female ratio. Most of the patients (75%) were aged between 18-30. 46.5% of subjects were classified as mild TBI while 12.7% and 40.8% were classified as moderate and severe TBI respectively using Glasgow Coma Scale. Motor vehicle accidents were the most common cause of TBI (91.7%), followed by falls from height (8.3%), (28.1%) of patients were underweight BMI<18.5 kg/m² while (16.9%) and (7.1%) were overweight and obese respectively.

Conclusion: NRI is more predictive malnutrition assessment tool than MUST in TBI patients. The higher sensitivities of NRI (92.9%) mean it is the better screening tool because there is a possibility that only 5%-7% of patients who may be malnourished were not correctly identified. Early recognition and management may help decrease hospital lengths of stay, readmission rates and associated healthcare costs