Newsletter

[ Vol. 12 No. 3 ] (September - December 2011 )
Clinical experience with BNT vs SGA on nutrition screening

Vibul Trakulhoon
Bhumibol Adulyadej Hospital, Thailand

INTRODUCTION
Screening and assessment of nutritional status are an essential fundamental step for good patient care. There are various tools available for this purpose. Yet, there is no single tool that can diagnose malnutrition accurately in all settings. However, Subjective Global Assessment (SGA) has been used widely. BNT (Bhumibol Adulyadej Hospital Nutrition Triage) is also a screening tool which includes all the malnutrition-related factors as in SGA.

OBJECTIVE
The objective of this project was to study the clinical application of BNT as compared to SGA on nutrition screening.

METHOD
In 2002, BNT and SGA (as gold standard) were tested for inter-observer reliability by two examiners (surgical residents). Both tools were applied to screen nutrition status in 50 surgical patients within 24-48 hours after admission. In 2006, the two nutrition screening tools were used to study the prevalence of nutrition status in 339 surgical patients.

RESULTS
The study in 2002 revealed that the lowest score of BNT to indicate malnutrition was 7 and the specificity, sensitivity and accuracy were 97.56%, 88.88% and 96% respectively. The second study revealed that the rating of malnutrition levels were comparable between SGA and BNT. The SGA-A was found in 259 (76.4%) patients compared to BNT-1 (score 0-4) in 263 patients (77.6%); The SGA-B was found in 64 patients (18.9%) compared to BNT-2 (score 5-8) in 59 patients (17.3%) ; The SGA-C was found in 16 patients (4.7%) compared to BNT-3,4 (score > 9) in 17 patients (5.1%); and the LOS also comparable.

SUMMARY
BNT can be used as a nutrition screening tool. BNT has more comfortable aspects such as scoring of screening parameters to rate the severity of malnutrition-related factors (from normal to severe level e.g. 0,1,2,3,4). No calculation was needed because the BMI table and % BW changed in graphic pattern are available.

CONCLUSION
BNT offers a simply, easy, numerical, practical, predictable and less time consuming tool for nutrition screening.

From  
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 69