For healthcare professionals
NRS 2002 nutritional risk screening
Nutritional Risk Screening 2002 (NRS 2002) flags adults in hospital who are at nutritional risk and may benefit from a nutritional care plan. This tool is written for clinicians and ward teams. It is not a self-check and not a diagnosis of malnutrition.
Step 1: initial screening
For an adult in hospital. Nothing you enter leaves this page.
Step 2: final screening
Needed only if any answer in step 1 is yes. Pick the worst grade that fits.
What you will see
Whether the initial screen is positive, then the NRS 2002 score from 0 to 7, the points for each part and whether the total reaches the nutritional risk mark of 3.
Educational only, not medical advice. A score never replaces the judgment of the treating team.
Source
NRS 2002 by Kondrup and colleagues for the ESPEN working group, Clinical Nutrition 2003, with the questions, grades and cut-off as printed in Table 1 of the open access study by Ozsenel and colleagues, Journal of Clinical Medicine 2025 (CC BY 4.0), checked grade by grade against the Methods of Jin and colleagues, BMC Endocrine Disorders 2022 (CC BY 4.0). The initial screening BMI question (below 20.5) is as printed in Table 1 of Kabashneh and colleagues, Cureus 2020 (CC BY 3.0). The wording on this page is our own. The tests check every grade, the age edge at 70, the risk mark of 3 and the maximum of 7.
Validated in
NRS 2002 was built for adults in hospital. Kondrup and colleagues based it on an analysis of controlled clinical trials of nutritional support; we cite that paper but do not quote it, because its license does not allow reuse here. Ozsenel and colleagues used it in a point prevalence study of adult inpatients at a tertiary care hospital in Turkey, and Jin and colleagues in older inpatients with diabetes and lacunar stroke in China.
Limits
For adults in hospital, not for children or for screening in the community. It is a screen for risk, not a diagnosis of malnutrition; in the printed tool a positive screen leads to a nutritional care plan. The disease examples are a guide; grade other conditions by how close they come to the examples. The weight loss and intake items depend on history that may be uncertain. Open copies differ slightly in wording: one prints the initial BMI question as below 20 rather than 20.5, and studies describe the age point as over 70 or as 70 or more; this tool uses 20.5 and 70 or more.
The score, step by step
Initial screening, as printed in Kabashneh 2020 and Ozsenel 2025 (Kabashneh 2020) (Ozsenel 2025): is the BMI low, has the patient lost weight within the last 3 months, has food intake dropped in the last week, is the patient severely ill. If every answer is no, the patient is screened again once a week, and a nutritional plan should be made if a major operation is planned. If any answer is yes, go on to the final screening (Kondrup 2003).
Final screening, as printed in Ozsenel 2025 and Jin 2022 (Ozsenel 2025) (Jin 2022):
- Impaired nutritional status: absent 0; mild 1 (weight loss over 5% in 3 months, or intake 50 to 75% of normal need in the preceding week); moderate 2 (weight loss over 5% in 2 months, or BMI 18.5 to 20.5 with impaired general condition, or intake 25 to 50%); severe 3 (weight loss over 5% in 1 month or over 15% in 3 months, or BMI below 18.5 with impaired general condition, or intake 0 to 25%)
- Severity of disease: absent 0; mild 1 (hip fracture, chronic disease with acute complications such as cirrhosis, COPD, chronic hemodialysis, diabetes or cancer); moderate 2 (major abdominal surgery, stroke, severe pneumonia, blood cancer); severe 3 (head injury, bone marrow transplant, intensive care with APACHE II over 10)
- Age 70 or more: add 1
The total ranges from 0 to 7. Worked example: a 74 year old admitted with a stroke (2) who has lost just over 5% of body weight in 3 months (1) scores 2 + 1 + 1 = 4, at nutritional risk.
Reading the result
A total of 3 or more means the patient is at nutritional risk and a nutritional care plan is started; under 3, the patient is screened again weekly (Ozsenel 2025) (Jin 2022). The sources cited here do not give a single rate of complications or death for each score, so this page does not show one.
A positive screen is a prompt for the team to plan nutrition care, not a final label.
Related tools
For comorbidity burden, see the Charlson comorbidity index. For older adults, see the FRAIL scale and the SARC-F muscle loss screen. For BMI itself, use the BMI calculator. Other bedside scores are listed under For healthcare professionals.
Sources
- Özşenel EB, Kahveci G, Pekcioğlu Z, et al. The Overlooked Threat of Malnutrition: A Point Prevalence Study Based on NRS-2002 Screening in a Tertiary Care Hospital. J Clin Med. 2025;14(11):3976. doi:10.3390/jcm14113976. Open access (CC BY 4.0). Table 1: Nutritional Risk Screening 2002. pmc.ncbi.nlm.nih.gov/articles/PMC12155780/
- Jin Y, Wen X, Li Y, et al. Factors associated with higher falling risk in elderly diabetic patients with lacunar stroke. BMC Endocr Disord. 2022;22:198. doi:10.1186/s12902-022-01122-3. Open access (CC BY 4.0). Methods: NRS-2002 sections and cut-off. pmc.ncbi.nlm.nih.gov/articles/PMC9358832/
- Kabashneh S, Alkassis S, Shanah L, et al. A Complete Guide to Identify and Manage Malnutrition in Hospitalized Patients. Cureus. 2020;12(6):e8486. doi:10.7759/cureus.8486. Open access (CC BY 3.0). Table 1: NRS-2002 pre-screening questions. pmc.ncbi.nlm.nih.gov/articles/PMC7343301/
- Kondrup J, Rasmussen HH, Hamberg O, Stanga Z; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-336. doi:10.1016/s0261-5614(02)00214-5. PMID 12765673. Original paper (cited; the items used here are taken from the open access sources above). doi.org/10.1016/s0261-5614(02)00214-5
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-03. Spotted an error? See About.