Nutritional risk screening by the emergency medical services: Agreement with in-hospital assessment

Introduction: Early recognition of nutritional risk is important to prevent the adverse consequences of malnutrition. However, nutritional risk screening is often disregarded in hospitals. Purpose: To evaluate the agreement of nutritional risk screening results between screening performed by emergency medical services (EMS) and at the hospital ward. Methods: The EMS used the Nutritional Risk Screening 2002 (NRS-2002) to screen the nutritional risk of community-dwelling patients aged ≥ 70 years transported to the emergency department of a large Finnish hospital. The NRS-2002 results from the EMS were compared to results obtained during hospitalization. Results: The EMS screened 472 patients and recognized nutritional risk in 81 (17 %). NRS-2002 was repeated at hospital ward in 97 of the screened. In about two-thirds of the cases (69 %), the EMS and ward personnel agreed on whether the patient had nutritional risk or not, and one-third of patients (31/97, 32 %) had the exact same score. The EMS tended to give lower scores (mean difference 0.70 ± 1.29, p < 0.001). Twenty-four patients considered not to be at nutritional risk according to the EMS were recognized as risk patients at the ward. Conclusion: Nutritional risk screening by the EMS could help in identifying persons requiring more detailed assessment of nutritional status.