NRS-2002 • Inpatient Nutritional Screen
Impairment of Nutritional Status
Severity of Disease (Stress)
Patient is ≥ 70 years old?
Input the clinical status and disease severity parameters to visualize the inpatient nutritional risk profile.
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Standardized nutritional screening for hospitalized adult patients
To identify patients who are likely to benefit from specialized nutritional support (Enteral/Parenteral)
Required for many hospital accreditation and quality improvement protocols
The 'Risk' Definition
NRS-2002 defines risk as the "likelihood of better outcome with nutritional therapy." It combines nutritional depletion (Impairment) with the increased requirements of the current illness (Severity).
How it Works
The Two-Part System (Max 7 Points)
01
Part 1: Impaired Nutritional Status (0–3 pts): Based on BMI, weight loss, and recent food intake.
02
Part 2: Severity of Disease (0–3 pts): Reflecting increased metabolic demand (e.g., Hip fracture = 1, Major surgery = 2, ICU/Head injury = 3).
03
Age Modifier: Add 1 point if the patient is ≥ 70 years old.
Actionable Threshold
| Score < 3 | Low Risk. Re-screen weekly. |
| Score ≥ 3 | Nutritionally At Risk. Start nutritional plan. |
Clinical Pearls
Sensitivity to Metabolic Stress
The brilliance of NRS-2002 is that it recognizes a "well-nourished" patient with BMI 25 can still be at "nutritional risk" if they are admitted to the ICU with multi-organ failure. In this state, the metabolic requirement far exceeds body stores, and aggressive early nutrition (within 24–48 hours) improves survival.
ESPEN Approval
The NRS-2002 is the officially recommended screening tool for hospitalized patients by ESPEN (European Society for Clinical Nutrition and Metabolism).
Clinical Pearls
A 5% weight loss in 1 month or 15% in 3 months is heavily weighted in the impaired status score
The Age modifier (≥70) reflects the lower physiological resilience of the elderly to periods of starvation
Next Steps
Management Priority
01
Score ≥ 3: Clinical nutrition consult; aim for 25–30 kcal/kg/day; maximize protein intake (1.2–1.5 g/kg/day).
02
Score < 3: Monitor; Ensure "Mealtime assistance" if required.
The Evidence
The Definitive Paper
Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials.
Kondrup J et al. • Clinical Nutrition. 2003;22(3):321-36. The description and validation of the tool.
View Source• . ;
Origins & History
ESPEN Task Force
Developed by a working group in Copenhagen, Denmark. The team performed a meta-analysis of 128 randomized trials to determine which clinical features best predicted who would actually benefit from being fed in the hospital.
Last Comprehensive Review: 2026-07-17