Evidence map›Paper›PMID 40037524›Full record

Observational studyThe British journal of surgery2025

Multicentre prospective study on the diagnostic and prognostic validity of malnutrition assessment tools in surgery.

Georgia Petra, Evangelos I Kritsotakis, Nikolaos Gouvas, Dimitrios Schizas, Konstantinos Toutouzas, Michael Karanikas, George Pappas-Gogos, Georgios Stylianidis, George Zacharioudakis, Aggelos Laliotis and 4 more

Abstract readMulticenter StudyObservational StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Georgia PetraDepartment of General Surgery, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.ORCID 0000-0002-1254-5847
Evangelos I KritsotakisLaboratory of Biostatistics, Medical School, University of Crete, Heraklion, Crete, Greece.ORCID 0000-0002-9526-3852
Nikolaos GouvasDepartment of Surgery, University of Cyprus, School of Medicine, Nicosia, Cyprus.
Dimitrios Schizas1st Department of Surgery, Laikon Hospital, National and Kapodistrian University of Athens, Athens, Greece.ORCID 0000-0002-7046-0112
Konstantinos Toutouzas1st Propaedeutic Department of Surgery, Hippokrateio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Michael Karanikas1st Surgical Department, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece.
George Pappas-Gogos2nd Surgical Department, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece.
Georgios Stylianidis2nd Department of Surgery, Evangelismos General Hospital, Athens, Greece.
George Zacharioudakis5th Surgical Department of Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece.
Aggelos LaliotisDepartment of Surgery, Venizeleio Hospital, Heraklion, Crete, Greece.
Grigorios ChristodoulidisDepartment of Surgery, School of Medicine, University of Thessaly, Larissa, Greece.ORCID 0000-0003-3413-0666
Ioannis KehagiasDepartment of Surgery, School of Medicine, University of Patras, Patras, Greece.
Konstantinos LasithiotakisDepartment of General Surgery, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.ORCID 0000-0002-6538-0951
MATS Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalnutrition is a risk factor for postoperative morbidity but the optimal tool for the assessment of malnutrition is unclear.

methodsThis is a prospective multicentre cohort study. Consecutive patients undergoing elective or emergency major abdominal surgery for benign or malignant disease in 12 Greek hospitals between January 2022 and December 2023 were included. Patients unable to provide nutrition history and/or informed consent were excluded. Subjective global assessment (SGA) was used as a reference standard for malnutrition diagnosis. GLIM (global leadership initiative on malnutrition), MNA-SF (mini nutrition assessment short form), MST (malnutrition screening tool), MUST (malnutrition universal screening tool), NRI (nutritional risk index), NRS-2002 (nutrition risk scale 2002), PONS (perioperative nutrition screen) and SNAQ (short nutrition assessment questionnaire) tools were applied for malnutrition risk assessments. Indicators of diagnostic accuracy (sensitivity, specificity, diagnostic odds ratio, areas under the receiver operating characteristic curve-AUC), construct validity (convergent associations with relevant variables) and prognostic validity (logistic regression) were appraised.

results1649 patients were included (58% colorectal, 21% upper gastrointestinal, 14% hepatobiliary operations). SGA defined 562 (34.1%) patients as malnourished with excellent construct and prognostic validity. Malnutrition risk assessments varied from 24.0% using NRS-2002 to 58.6% with the MNA-SF. On their ordinal scales, MNA-SF (AUC = 0.83, 95% c.i. 0.81 to 0.85) and MUST (AUC = 0.79, 95% c.i. 0.77 to 0.82) had the best discriminatory abilities with minimal between-centre heterogeneity. As binary classifiers, MNA-SF (OR = 30.2; 95% c.i. 20.2 to 45.1) and MUST (OR = 16.1; 95% c.i. 12.4 to 21.1) had the highest diagnostic ORs but only MUST had sensitivity and specificity close to 80%. MUST performed well in construct and prognostic validity appraisals.

conclusionThis study supports the use of the MUST as it is the most valid nutritional screening tool in patients after major abdominal surgery.

Indexed as

MalnutritionNutrition AssessmentPostoperative ComplicationsAdultAgedFemaleHumansMaleMiddle AgedNutritional StatusPrognosisProspective StudiesReproducibility of ResultsRisk Assessment

Identifiers

PMID40037524
PMCPMC11879291

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.