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Archives of Medical Science
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vol. 14
Clinical research

Validity of the new nutrition screening tool Control of Food Intake, Protein, and Anthropometry (CIPA) in non-surgical inpatients

José Pablo Suárez-Llanos, Alejandra Mora-Mendoza, Néstor Benítez-Brito, Lina Pérez-Méndez, Francisca Pereyra-García-Castro, José Gregorio Oliva-García, José Enrique Palacio-Abizanda

Arch Med Sci 2018; 14, 5: 1020–1024
Online publish date: 2017/02/20
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There is no gold-standard method for hospital nutrition screening. The new screening tool termed Control of Food Intake, Protein, and Anthropometry (CIPA) gives positive results when at least one of the following parameters is met: control of food intake for 72 h < 50%, serum albumin < 3 g/dl, body mass index < 18.5 kg/m2 or mid-upper arm circumference ≤ 22.5 cm. This method was validated in comparison with Subjective Global Assessment (SGA) in hospitalized patients with non-surgical pathologies.

Material and methods
A prospective, longitudinal study was performed on 221 consecutively enrolled patients. Prevalence or risk of malnutrition was estimated with CIPA vs. SGA screening at hospital admission and the concordance ( index – K) between the two methods and their sensitivity (S) and specificity (SP) were studied. Mean length of stay (LOS), mortality, and rate of early readmission were analyzed.

The prevalence or risk of malnutrition identified by CIPA and SGA was 35.7% and 23.1%, respectively. K was 0.401 (p < 0.001); S and SP of CIPA vs. SGA were 72.5% and 75.3%, respectively. In contrast to SGA, CIPA-positive patients had an increased mean LOS compared to the negative ones (19.53 vs. 12.63 days, p < 0.001). Both methods detected a major risk of mortality in positive patients, but no difference in early readmission.

The CIPA and the SGA screening tools detect patients with a higher risk of mortality, but only CIPA identifies patients with an increased mean LOS. CIPA screening proved valid for use in non-surgical inpatients.


malnutrition, screening, health care quality, inpatient, nutrition assessment

Edington J, Boorman J, Durrant ER, et al. Prevalence of malnutrition on admission to four hospitals in England. The Malnutrition Prevalence Group. Clin Nutr 2000; 19: 191-5.
Alvarez-Hernandez J, Planas-Vila M, Leon-Sanz M, et al. Prevalence and costs of malnutrition in hospitalized patients: the PREDyCES Study. Nutr Hosp 2012; 27: 1049-59.
Sorensen J, Kondrup J, Prokopowicz J, et al. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr 2008; 27: 340-9.
Correia MI, Campos AC. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition 2003; 19: 823-5.
Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003; 22: 235-9.
Golabek T, Powroźnik J, Chłosta P, Dobruch J, Borówka A. The impact of nutrition in urogenital cancers. Arch Med Sci 2015; 11: 411-8.
Elia M, Normand C, Norman K, Laviano A. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in the hospital setting. Clin Nutr 2016; 35: 370-80.
Philipson TJ, Snider JT, Lakdawalla DN, Stryckman B, Goldman DP. Impact of oral nutritional supplementation on hospital outcomes. Am J Manag Care 2013; 19: 121-8.
Waitzberg DL, Correia MI. Nutritional assessment in the hospitalized patient. Curr Opin Clin Nutr Metab Care 2003; 6: 531-8.
Suárez Llanos JP, Benitez Brito N, Oliva García JG, et al. Introducing a mixed nutritional screening tool (CIPA) in a tertiary hospital. Nutr Hosp 2014; 29: 1149-53.
Benítez Brito N, Suárez Llanos JP, Fuentes Ferrer M, et al. Relationship between mid-upper arm circumference and body mass index in Inpatients. PLoS One 2016; 11: e0160480.
Benítez Brito N, Mora Mendoza A, Suárez Llanos JP, et al. Concordance in the results of control intake performance of 72h by different health professionals in a tertiary hospital. Nutr Hosp 2015; 32: 2895-9.
Burden ST, Brierley ER. Evaluation of adherence to a nutrition screening programme over a 5-year period. Eur J Clin Nutr 2014; 68: 847-52.
Van Bokhorst-de van der Schueren MA, Guaitoli PR, Jansma EP, de Vet HC. Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr 2014; 33: 39-58.
Velasco C, García E, Rodriguez V, et al. Comparison of four nutricional screening Tools to detect nutricional risk in hospitalizad patients: a multicentre study. Eur J Clin Nutr 2011; 65: 269-74.
Kondrup J, Rasmussen HH, Hamberg O, Stanga Z. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 2003; 22: 321-36.
Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? JPEN
J Parenter Enteral Nutr 1987; 11: 8-13.
Kruizenga HM, Seidell JC, de Vet HC, Wierdsma NJ, van Bokhorst-de van der Schueren MA. Development and validation of a hospital screening tool for malnutrition: the short nutritional assessment questionnaire (SNAQ). Clin Nutr 2005; 24: 75-82.
Ferguson M, Capra S, Bauer J, Banks M. Development of a valid and reliable malnutrition screening tool for adult acute hospital patients. Nutrition 1999; 15: 458-64.
Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 2001; 56: M366-72.
Lobo Támer G, Ruiz López MD, Pérez de la Cruz AJ. Hospital malnutrition: relation between the hospital length of stay and the rate of early readmissions. Med Clin 2009; 132: 377-84.
Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition – an ESPEN Consensus Statement. Clin Nutr 2015; 34: 335-40.
da Silva, FJ, Mello P, De Luis D, Mello E. Subjective global assessment of nutritional status – a systematic review of the literature. Clin Nutr 2015; 34: 785-92.
Neelemat F, Meijers J, Kruizenga H, Van Ballegooijen H, van Bockhorst-de van der Schueren. Comparison of five malnutrition screening tools in one hospital inpatient sample. J Clin Nurs 2011; 20: 2144-52.
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