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Nutritional Risk Screening NRS 2002 Guide

This document describes the Nutritional Risk Screening 2002 tool for assessing patient nutritional risk. It involves an initial screening using 4 questions to determine if further screening is needed. If further screening is needed, Table 2 is used to assess severity of nutritional impairment and disease severity on a scale of 0-3. Scores are combined for a total risk score. A score of 3 or higher indicates nutritional risk and requires a nutritional care plan. The document also provides examples of nutritional requirements and interventions needed for different total risk scores.

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Naufal Ahmad
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15K views1 page

Nutritional Risk Screening NRS 2002 Guide

This document describes the Nutritional Risk Screening 2002 tool for assessing patient nutritional risk. It involves an initial screening using 4 questions to determine if further screening is needed. If further screening is needed, Table 2 is used to assess severity of nutritional impairment and disease severity on a scale of 0-3. Scores are combined for a total risk score. A score of 3 or higher indicates nutritional risk and requires a nutritional care plan. The document also provides examples of nutritional requirements and interventions needed for different total risk scores.

Uploaded by

Naufal Ahmad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Nutritional Risk Screening (NRS 2002)

Table 1: Initial screening Yes No


1 Is BMI <20?
2 Has the patient lost weight within the last 3 months?
3 Has the patient had a reduced dietary intake in the last week?
4 Is the patient severely ill ? (e.g. in intensive therapy)
Yes: If the answer is 'Yes' to any question, the screening in Table 2 is performed.
No: If the answer is 'No' to all questions, the patient is re-screening at weekly intervals. If the patient e.g. is scheduled for
a major operation, a preventive nutritional care plan is considered to avoid the associated risk status.

Table 2: Final screening


Impaired nutritional status Severity of disease ( increase in requirements)

Absent Normal nutritional status Absent Normal nutritional requirements


Score 0 Score 0
Wt loss >5% in 3 mths Hip fracture*
Mild or Mild Chronic patients, in particular with acute compli-
Food intake below 50-75% of normal re- cations: cirrhosis*, COPD*.
quirement in preceding week. Chronic hemodialysis, diabetes, oncology.
Score 1 Score 1
Wt loss >5% in 2 mths Major abdominal surgery*
Moderate or Moderate Stroke*
BMI 18.5 - 20.5 + impaired general con- Severe pneumonia, hematologic malignancy.
dition
or
Food intake 25-50% of normal require-
ment in preceding week
Score 2 Score 2
Wt loss >5% in 1 mth (>15% in 3 mths) Head injury*
Severe or Severe Bone marrow transplantation*
BMI <18.5 + impaired general condition Intensive care patients (APACHE>10).
or
Food intake 0-25% of normal requirement
in preceding week in preceding week.
Score 3 Score 3
Score: + Score: = Total score:
Age if 70 years: add 1 to total score above = age-adjusted total score:
Score 3: the patient is nutritionally at-risk and a nutritional care plan is initiated
Score < 3: weekly rescreening of the patient. If the patient e.g. is scheduled for a major operation, a preventive nutrition-
al care plan is considered to avoid the associated risk status.

NRS-2002 is based on an interpretation A nutritional care plan is indicated in bed regularly. Protein requirement is in-
of available randomized clinical trials. all patients who are creased, but can be covered by oral diet or
* indicates that a trial directly supports 1) severely undernourished (score =3), supplements in most cases.
the categorization of patients with that 2) severely ill (score = 3), Score = 2: a patient confined to bed due to
diagnosis. Diagnoses shown in italics 3) moderately undernourished + mildly illness, e.g. following major abdominal sur-
are based on the prototypes given below. ill (score 2 +1), or gery. Protein requirement is substantially in-
4) mildly undernourished + moderately creased, but can be covered, although artifi-
Nutritional risk is defined by the pres- ill (score 1 + 2). cial feeding is required in many cases.
ent nutritional status and risk of im- Score = 3: a patient in intensive care with
pairment of present status, due to in- Prototypes for severity of disease assisted ventilation etc. Protein requirement
creased requirements caused by stress Score = 1: a patient with chronic disea- is increased and cannot be covered even by
metabolism of the clinical condition. se, admitted to hospital due to compli- artificial feeding. Protein breakdown and
cations. The patient is weak but out of nitrogen loss can be significantly attenuated.

16-11-17

Nutritional Risk Screening (NRS 2002) Table 1: Initial screening Yes No 1 Is BMI <20? 2 Has the patient lost weight w

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