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Simple pediatric nutritional risk score to identify children at risk of malnutrition
I Sermet-Gaudelus1, A S Poisson-Salomon, V Colomb
1Pediatric Department, Hôpital Necker-Enfants Malades, Paris, France.
Insights
A new pediatric nutritional risk score identifies hospitalized children at risk of malnutrition. This simple tool, based on food intake and medical condition, helps prevent hospital-acquired malnutrition.
Area of Science:
- Pediatric Nutrition
- Clinical Assessment
- Hospital Malnutrition
Background:
- Hospitalized children face malnutrition risks.
- Lack of validated tools hinders routine nutritional screening.
- Early identification of at-risk children is crucial.
Purpose of the Study:
- Develop a simple pediatric nutritional risk score.
- Identify children at risk of acute malnutrition upon hospital admission.
- Facilitate early intervention to prevent malnutrition.
Main Methods:
- Prospective assessment of 296 children within 48 hours of admission.
- Evaluation of anthropometrics, food intake, feeding ability, medical condition, and interfering symptoms.
- Stepwise logistic regression to identify risk factors for weight loss.
Main Results:
- 65% of children experienced weight loss during hospitalization; 45% lost >2% of admission weight.
- Low food intake (<50%), pain, and severe pathology (grades 2 and 3) were significant predictors of weight loss (>2%).
- A nutritional risk score (0-5) was developed, with scores ≥3 indicating high malnutrition risk.
Conclusions:
- A simple, validated nutritional risk score can be routinely used at admission.
- This score effectively identifies children at risk of malnutrition during hospitalization.
- Implementation of this score can help prevent hospital-acquired malnutrition.
Background:
Although hospitalized children are at risk of malnutrition, routine screening of nutritional status has been hindered by lack of a validated nutritional assessment tool.
Objective:
Our aim was to develop a simple pediatric nutritional risk score that could be used at hospital admission to identify patients at risk of acute malnutrition during hospitalization.
Design:
Nutritional risk was assessed prospectively in 296 children. Anthropometric measurements, food intake, ability to eat and retain food, medical condition, and symptoms interfering with feeding (pain, dyspnea, and depression) were evaluated within 48 h of admission. Pathology was classified as mild (grade 1), moderate (grade 2), or severe (grade 3). The risk of weight loss was investigated with stepwise logistic regression.
Results:
Weight loss during hospitalization occurred in 65% of the children and was >2% of admission weight in 45% of patients. Multivariate analysis indicated that food intake <50%, pain, and grade 2 and 3 pathologic conditions (P = 0.0001 for all) were associated with weight losses of >2%. The nutritional risk score ranged from 0 to 5 and was calculated by adding the values for the significant risk factors as follows: 1 for food intake <50%, 1 for pain, 1 for grade 2 pathologic condition, and 3 for grade 3 pathologic condition. A score of 1 or 2 indicated moderate risk and a score >/=3 indicated high risk of malnutrition.
Conclusions:
This simple score is suitable for routine use to identify patients at risk of malnutrition during hospitalization. Implementation may prevent hospital-acquired malnutrition.