Comparison of four different nutritional risk screening tools in hospitalized children

Authors

Keywords:

Child, hospitalized, Malnutrition, Nutrition assessment

Abstract

Objective
Early detection of malnutrition risk in hospitalized children can improve health outcomes and Nquality of life; however, the number of studies where the pediatric screening tool is appropriate for Turkish children is limited. Therefore, this article aims to determine the prevalence of malnutrition risk in pediatric patients evaluated with Screening Tool for Risk on Nutritional Status and Growth, Screening Tool for the Assessment of Malnutrition in Pediatrics, Pediatric Yorkhill Malnutrition Score, and Simple Pediatric Nutrition Screening Tool with original and adjusted cutoffs and to evaluate which pediatric screening tool is appropriate for Turkish children.
Methods
In this cross-sectional study, four published nutritional risk screening tools (Screening Tool for Risk on Nutritional Status and Growth, Screening Tool for the Assessment of Malnutrition in Pediatrics, Pediatric Yorkhill Malnutrition Score, Pediatric Nutrition Screening Tool) were applied to pediatric inpatients (n=604) aged 1 month to 17 years, admitted to a pediatric ward for at least 24 hours.
Results
Pediatric Nutrition Screening Tool with adjusted cutoffs had the greatest recognition rate (94.2%) of acute malnutrition. Having a high nutritional risk by Pediatric Yorkhill Malnutrition Score was associated with an increased risk of acute (OR: 6.57 for Screening Tool for Risk on Nutritional Status and Growth, 5.84 for Screening Tool for the Assessment of Malnutrition in Pediatrics, and 20.35 for Pediatric Yorkhill Malnutrition Score) and chronic malnutrition (OR: 1.27 for Screening Tool for Risk on Nutritional Status and Growth, 3.28 for Screening Tool for the Assessment of Malnutrition in Pediatrics, and 1.72 for Pediatric Yorkhill Malnutrition Score). Classifying the at-risk category by the Pediatric Nutrition Screening Tool was related to raised odds of malnutrition (OR: 2.64 for original and 5.24 for adjusted cutoffs). This positive association was also observed for acute (OR: 4.07 for original cutoffs, and 28.01 for adjusted cutoffs) and chronic malnutrition (OR: 1.14 for original cutoffs, and 1.67 for adjusted cutoffs).

Conclusion
Pediatric Nutrition Screening Tool with adjusted cutoffs and Pediatric Yorkhill Malnutrition Score have higher diagnostic accuracy than other screening tools in assessing the nutritional status of hospitalized Turkish children and detecting children, particularly with acute malnutrition.

References

Mehta NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney L, et al. Defining pediatric malnutrition: A paradigm shift toward etiology-related definitions. J Parenter Enter Nutr. 2013 [cited 2021 Sep 30];37(4):460- 81. Available from: https://onlinelibrary.wiley.com/doi/full/10.1177/0148607113479972

Rinninella E, Ruggiero A, Maurizi P, Triarico S, Triarico S, Cintoni M. Clinical tools to assess nutritional risk and malnutrition in hospitalized children and adolescents. Eur Rev Med Pharmacol Sci. 2017 [cited 2022 Apr 7];21:2690-701. Available from: https://publires.unicatt.it/en/publications/clinical-tools-to-assess-nutritional-risk-and-malnutrition-in-hos-8

Daskalou E, Galli-Tsinopoulou A, Karagiozoglou-Lampoudi T, Augoustides-Savvopoulou P. Malnutrition in Hospitalized pediatric patients: assessment, prevalence, and association to adverse outcomes. J Am Coll Nutr. 2015;34(4):372-80. https://doi.org/10.1080/07315724.2015.1056886

Gerasimidis K, Macleod I, Maclean A, Buchanan E, McGrogan P, Swinbank I, et al. Performance of the novel Paediatric Yorkhill Malnutrition Score (PYMS) in hospital practice. Clin Nutr. 2011;30(4):430-5.

White M, Lawson K, Ramsey R, Dennis N, Hutchinson Z, Soh XY, et al. Simple nutrition screening tool for pediatric inpatients. J Parenter Enter Nutr. 2016;40(3):392-8. https://doi.org/10.1177/0148607114544321

Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415-21.

Agostoni C, Axelson I, Colomb V, Goulet O, Koletzko B, Michaelsen KF, et al. The need for nutrition support teams in pediatric units: a commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr. 2005;41(1):8-11. https://doi.org/10.1097/01.MPG.0000163735.92142.87

Beser OF, Cokugras FC, Erkan T, Kutlu T, Yagci R V., Ertem D, et al. Evaluation of malnutrition development risk in hospitalized children. Nutrition. 2018;48:40-7.

Hulst JM, Zwart H, Hop WC, Joosten KFM. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children. Clin Nutr. 2010;29(1):106-11.

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©) for use by healthcare staff. J Hum Nutr Diet. 2012;25(4):311-8. https://doi.org/10.1111/j.1365-277X.2012.01234.x

World Health Organization. WHO AnthroPlus for Personal Computers Manual: software for assessing growth of the world ’ s children and adolecents. Geneva: Organization; 2009 [cited 2022 Sep 7]. Available from: https://www.who.int/tools/growth-reference-datafor-5to19-years

World Health Organization. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: Organization; 2006 [cited 2022 Sep 7]. Available from: https://www.who.int/publications/i/item/924154693X

Carter LE, Shoyele G, Southon S, Farmer A, Persad R, Mazurak VC, et al. Screening for Pediatric Malnutrition at Hospital Admission: Which Screening Tool Is Best? Nutr Clin Pract. 2020 [cited 2022 Jun 9];35(5):951-8. Available from: /pmc/articles/PMC7539919/

Mercaldo ND, Lau KF, Zhou XH. Confidence intervals for predictive values with an emphasis to case-control studies. Stat Med. 2007 [cited 2022 Dec 27];26(10):2170-83. Available from: https://pubmed.ncbi.nlm.nih.gov/16927452/

Durakbaşa ÇU, Fettahoğlu S, Bayar A, Mutus M, Okur H. The prevalence of malnutrition and effectiveness of STRONGkids tool in the identification of malnutrition risks among pediatric surgical patients. Balkan Med J. 2014 [cited 2022 Jun 16];31(4):313-21. Available from: . https://pmc/articles/PMC4318402/

Taşcı O, Soylu ÖB, Taşcı EK, Eser E, Oruçoğlu B, Günay İ. Validity and reliability analysis of the Turkish version of pediatric nutritional risk score scale. Turkish J Gastroenterol. 2020 [cited 2022 Jun 16];31(4):324- 30. Available from: /pmc/articles/PMC7236646/

McCarthy A, Delvin E, Marcil V, Belanger V, Marchand V, Boctor D, et al. Prevalence of malnutrition in pediatric hospitals in developed and in-transition countries: the impact of hospital practices. Nutrients. 2019;11(2):236doi.org/10.3390/nu11020236

World Health Organization. Children: Improving Survival and Well-Being. Geneva: Organization; 2020 [cited 2022 Jun 16]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/children-reducing-mortality

Chourdakis M, Hecht C, Gerasimidis K, Joosten KFM, Karagiozoglou-Lampoudi T, Koetse HA, et al. Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population. Am J Clin Nutr. 2016 [cited 2022 Jun 16];103(5):1301-10. Available from: https://academic.oup.com/ajcn/article/103/5/1301/4637451

Huysentruyt K, Alliet P, Muyshont L, Rossignol R, Devreker T, Bontems P, et al. The STRONGkids nutritional screening tool in hospitalized children: a validation study. Nutrition. 2013;29(11-12):1356-61.

Aurangzeb B, Whitten KE, Harrison B, Mitchell M, Kepreotes H, Sidler M, et al. Prevalence of malnutrition and risk of under-nutrition in hospitalized children. Clin Nutr. 2012;31(1):35-40.

Wonoputri N, Djais JTB, Rosalina I. Validity of Nutritional Screening Tools for Hospitalized Children. J Nutr Metab. 2014 [cited 2022 Jun 17];2014:143649. Available from: https://pubmed.ncbi.nlm.nih.gov/25298890/

Pars H, Açıkgöz A, Erdoğan BD. Validity and reliability of the Turkish version of three screening tools (PYMS, STAMP, and STRONG-kids) in hospitalized children. Clin Nutr ESPEN. 2020;39:96-103.

Pérez-Solís D, Larrea-Tamayo E, Menéndez-Arias C, Molinos-Norniella C, Bueno-Pardo S, Jiménez-Treviño S, et al. Assessment of two nutritional screening tools in hospitalized children. Nutrients. 2020 [cited 2022 Jun 17];12(5):1221. Available from: https://www.mdpi.com/2072-6643/12/5/1221/htm

Santos CA, Rosa COB, Franceschini SCC, Castro JS, Costa IBM, Firmino HH, et al. StrongKids for pediatric nutritional risk screening in Brazil: a validation study. Eur J Clin Nutr. 2020;74(9):1299-305. https://doi.org/10.1038/s41430-020-0644-1

Grek J, Puntis J. Nutritional assessment of acute medical admissions is still done badly despite “nutrition screening”. Arch Dis Child. 2013 [cited 2022 Jun 21];98(11):922-3. Available from: https://pubmed.ncbi. nlm.nih.gov/23940235/

Milani S, Wright C, Purcell O, Macleod I, Gerasimidis K. Acquisition and utilisation of anthropometric measurements on admission in a paediatric hospital before and after the introduction of a malnutrition screening tool. J Hum Nutr Diet. 2013 [cited 2022 Jun 21];26(3):294-7. Available from: https://pubmed. ncbi.nlm.nih.gov/23560868/

Published

2023-10-25

How to Cite

KAYA, D. G., AKIN, Z. C., Orucoglu, B., & CELIK, E. (2023). Comparison of four different nutritional risk screening tools in hospitalized children. Brazilian Journal of Nutrition, 36. Retrieved from https://seer.sis.puc-campinas.edu.br/nutricao/article/view/10180

Issue

Section

ORIGINAL ARTICLE