Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
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Comparison of four nutritional screening tools for Korean hospitalized children

  • Lee, Yeoun Joo (Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University College of Medicine) ;
  • Yang, Hye Ran (Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine)
  • Received : 2019.02.20
  • Accepted : 2019.08.21
  • Published : 2019.10.01
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Abstract

BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

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References

  1. Joosten KF, Hulst JM. Prevalence of malnutrition in pediatric hospital patients. Curr Opin Pediatr 2008;20:590-6. https://doi.org/10.1097/MOP.0b013e32830c6ede
  2. Marginean O, Pitea AM, Voidazan S, Marginean C. Prevalence and assessment of malnutrition risk among hospitalized children in Romania. J Health Popul Nutr 2014;32:97-102.
  3. Chourdakis M, Hecht C, Gerasimidis K, Joosten KF, Karagiozoglou-Lampoudi T, Koetse HA, Ksiazyk J, Lazea C, Shamir R, Szajewska H, Koletzko B, Hulst JM. Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population. Am J Clin Nutr 2016;103:1301-10. https://doi.org/10.3945/ajcn.115.110700
  4. Nasab MH, Gholampour Z, Imani B, Norouzy A. Prevalence of malnutrition risk based on three nutritional risk scores in hospitalized Iranian children. Int Res J Appl Basic Sci 2016;10:438.
  5. Hwang EH, Park JH, Chun P, Lee YJ. Prevalence and risk factors for the weight loss during hospitalization in children: a single Korean children's hospital experience. Pediatr Gastroenterol Hepatol Nutr 2016;19:269-75. https://doi.org/10.5223/pghn.2016.19.4.269
  6. Lee DG, Rho YI, Moon KR. Assessment of nutritional status in hospitalized pediatric patients. Korean J Pediatr Gastroenterol Nutr 2001;4:83-91. https://doi.org/10.5223/kjpgn.2001.4.1.83
  7. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M; Educational and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22:415-21. https://doi.org/10.1016/S0261-5614(03)00098-0
  8. Reilly HM, Martineau JK, Moran A, Kennedy H. Nutritional screening--evaluation and implementation of a simple nutrition risk score. Clin Nutr 1995;14:269-73. https://doi.org/10.1016/S0261-5614(95)80063-8
  9. Detsky AS, Baker JP, Mendelson RA, Wolman SL, Wesson DE, Jeejeebhoy KN. Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparisons. JPEN J Parenter Enteral Nutr 1984;8:153-9. https://doi.org/10.1177/0148607184008002153
  10. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev 1996;54:S59-65. https://doi.org/10.1111/j.1753-4887.1996.tb03820.x
  11. Duran Alert P, Mila Villarroel R, Formiga F, Virgili Casas N, Vilarasau Farre C. Assessing risk screening methods of malnutrition in geriatric patients: mini nutritional assessment (MNA) versus geriatric nutritional risk index (GNRI). Nutr Hosp 2012;27:590-8.
  12. Abd Aziz NAS, Teng NIMF, Abdul Hamid MR, Ismail NH. Assessing the nutritional status of hospitalized elderly. Clin Interv Aging 2017;12:1615-25. https://doi.org/10.2147/CIA.S140859
  13. Hakonsen SJ, Pedersen PU, Bath-Hextall F, Kirkpatrick P. Diagnostic test accuracy of nutritional tools used to identify undernutrition in patients with colorectal cancer: a systematic review. JBI Database System Rev Implement Rep 2015;13:141-87. https://doi.org/10.11124/01938924-201513040-00012
  14. Lee YJ. Nutritional screening tools among hospitalized children: from past and to present. Pediatr Gastroenterol Hepatol Nutr 2018;21:79-85. https://doi.org/10.5223/pghn.2018.21.2.79
  15. Sermet-Gaudelus I, Poisson-Salomon AS, Colomb V, Brusset MC, Mosser F, Berrier F, Ricour C. Simple pediatric nutritional risk score to identify children at risk of malnutrition. Am J Clin Nutr 2000;72:64-70. https://doi.org/10.1093/ajcn/72.1.64
  16. Secker DJ, Jeejeebhoy KN. Subjective global nutritional assessment for children. Am J Clin Nutr 2007;85:1083-9. https://doi.org/10.1093/ajcn/85.4.1083
  17. Gerasimidis K, Keane O, Macleod I, Flynn DM, Wright CM. A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital. Br J Nutr 2010;104:751-6. https://doi.org/10.1017/S0007114510001121
  18. Hulst JM, Zwart H, Hop WC, Joosten KF. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children. Clin Nutr 2010;29:106-11. https://doi.org/10.1016/j.clnu.2009.07.006
  19. McCarthy H, Dixon M, Crabtree I, Eaton-Evans MJ, McNulty H. The development and evaluation of the screening tool for the assessment of malnutrition in paediatrics (STAMP(C)) for use by healthcare staff. J Hum Nutr Diet 2012;25:311-8. https://doi.org/10.1111/j.1365-277X.2012.01234.x
  20. White M, Lawson K, Ramsey R, Dennis N, Hutchinson Z, Soh XY, Matsuyama M, Doolan A, Todd A, Elliott A, Bell K, Littlewood R. Simple nutrition screening tool for pediatric inpatients. JPEN J Parenter Enteral Nutr 2016;40:392-8. https://doi.org/10.1177/0148607114544321
  21. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, Oh K, Jang MJ, Hwang SS, Yoo MH, Kim YT, Lee CG. 2007 Korean national growth charts: review of developmental process and an outlook. Korean J Pediatr 2008;51:1-25. https://doi.org/10.3345/kjp.2008.51.1.1
  22. Thomas PC, Marino LV, Williams SA, Beattie RM. Outcome of nutritional screening in the acute paediatric setting. Arch Dis Child 2016;101:1119-24. https://doi.org/10.1136/archdischild-2016-310484

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