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    Nutrition Risk Screening 2002 (NRS-2002)

    Predicts risk of malnutrition in hospitalized patients, recommended by ACG guidelines.
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    When to Use
    Why Use

    • Hospitalized patients at risk for malnutrition.
    • For ICU patients, the NUTRIC Score is a more widely validated risk predictor.

    If “Yes” to any, proceed to Final Screening. If ALL 4 Initial Screening questions are “No”, then the patient is low risk by NRS-2002.
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Consider nutrition consult in patients at risk for malnutrition.

    Formula

    Initial Screening: If “Yes” to any, proceed to Final Screening.

    BMI <20.5 kg/m²

    Yes / No

    Weight loss within 3 months

    Yes / No

    Reduced dietary intake in the last week

    Yes / No

    ICU patient

    Yes / No

    Final Screening: addition of the selected points.

         

    Nutritional impairment

    None

    0 points

    Mild: weight loss >5% in 3 months or food intake <50–75% of normal requirement in the preceding week

    1 point

    Moderate: weight loss >5% in 2 months or BMI 18.5–20.5 plus impaired general condition or food intake 25–60% of normal requirement in preceding week

    2 points

    Severe: weight loss >5% in 1 month (>15% in 3 months) or BMI <18.5 plus impaired general condition or food intake 0–25% of normal requirement in preceding week

    3 points

    Severity of disease

    Normal nutritional requirement

    0 points

    Hip fracture, chronic illness (may have acute complications, e.g. cirrhosis or COPD), chronic dialysis, diabetes, cancer

    1 point

    Major abdominal surgery, stroke, severe pneumonia, hematologic malignancy

    2 points

    Head injury, bone marrow transplant, ICU patient with APACHE >10

    3 points

    Age

    <70 years

    0 points

    ≥70 years

    1 point

    Facts & Figures

    Interpretation:

    NRS-2002

    Risk group

    Recommendation

    0-3

    Low risk

    Re-screen weekly

    4

    At risk

    Initiate nutritional care plan (food, oral supplements, tube feeding, and/or parenteral nutrition as appropriate)

    5-7

    High risk

    Initiate early intervention nutritional care plan

    From ASPEN guidelines 2016.

    Literature

    Dr. Jens Kondrup

    About the Creator

    Jens Kondrup, MD, is a senior physician at Rigshospitalet in Copenhagen, Denmark. He is the chair of the Danish Society of Clinical Nutrition. Dr. Kondrup is a former professor in the department of nutrition at the University of Copenhagen.

    To view Dr. Jens Kondrup's publications, visit PubMed

    About the Creator
    Dr. Jens Kondrup
    Guidelines