Malnutrition Universal Screening Tool (MUST)

Optimal nutrition is meant to prevent deterioration of mental and physical functions as well as health or treatment complications and to shorten convalescence. The purpose of the «Malnutrition Universal Screening Tool» (MUST) is to detect existing malnutrition mainly in the outpatient setting, but also in nursing homes and hospitals. The implementation of the MUST is recommended by the «European Society for Clinical Nutrition and Metabolism» (ESPEN) for outpatients [1].

Body Mass Index
Unplanned weight loss in the past 3–6 months
Acutely ill patient with food abstinence > 5 days (also expected)

Interpretation
Points Risk Recommendation
0 Low risk for malnutrition

Repeat Screening:

  • Hospital: weekly
  • Nursing home: monthly
  • Practice: annually for risk groups (e. g. age > 75 years)
1 Moderate risk for malnutrition

Observe:

  • Nutrition protocol over 3 days (hospital and nursing home)

Repeat Screening:

  • Hospital: weekly
  • Nursing home: monthly
  • Practice: every 2–3 months
≥ 2 High risk for malnutrition

Treat:

  • Begin nutrition therapy

Review of therapy:

  • Hospital: weekly
  • Nursing home: monthly
  • Practice: monthly
References
  1. Kondrup J, Allison SP, Elia M et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22:415-421
  2. Vellas B, Guigoz Y, Garry PJ et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15: 116-122

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