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Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting
Maria Immacolata Spagnuolo, Ilaria Liguoro, Fabrizia Chiatto
1Department of Translational Medical Science - Section of Pediatrics, University of Naples "Federico II", Naples, Italy. alfguari@unina.it.
Insights
The Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids) effectively identifies hospitalized children at risk for malnutrition. While sensitive, it requires integration with clinical data for accurate prediction.
Area of Science:
- Pediatric Nutrition
- Clinical Assessment Tools
- Hospital Malnutrition
Background:
- Hospitalization presents an unpredictable malnutrition risk, particularly for children with chronic diseases.
- The Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids) was developed to assess malnutrition risk in pediatric populations.
- Investigated the role of age and comorbidities in predicting malnutrition risk.
Purpose of the Study:
- To evaluate the applicability of the STRONGkids tool in hospitalized children.
- To assess the correlation between STRONGkids scores and actual nutritional status.
- To determine the influence of age and comorbidities on malnutrition risk.
Main Methods:
- A prospective, observational, multi-center study involving 12 Italian hospitals.
- Enrolled 144 children aged 1-18 years admitted to the hospital.
- STRONGkids scores were compared with nutritional status indicators like BMI and Height for Age SD-scores.
Main Results:
- 36% of enrolled children had an underlying chronic disease.
- STRONGkids classified 32% as low risk, 53% as moderate risk, and 15% as high risk for malnutrition.
- Children in the high-risk group exhibited significantly lower Height for Age and BMI SD-scores, though only 29 children were actually malnourished.
Conclusions:
- The STRONGkids tool is simple to administer and demonstrates high sensitivity for identifying at-risk children.
- The tool's specificity is limited, suggesting it should be used as a preliminary screening measure.
- Integrating STRONGkids results with other clinical data is recommended for reliable malnutrition risk prediction.
Background:
An increased but unpredictable risk of malnutrition is associated with hospitalization, especially in children with chronic diseases. We investigated the applicability of Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids), an instrument proposed to estimate the risk of malnutrition in hospitalized children. We also evaluated the role of age and co-morbidities as risk for malnutrition.
Methods:
The STRONGkids consists of 4 items providing a score that classifies a patient in low, moderate, high risk for malnutrition. A prospective observational multi-centre study was performed in 12 Italian hospitals. Children 1-18 years consecutively admitted and otherwise unselected were enrolled. Their STRONGkids score was obtained and compared with the actual nutritional status expressed as BMI and Height for Age SD-score.
Results:
Of 144 children (75 males, mean age 6.5 ± 4.5 years), 52 (36%) had an underlying chronic disease. According to STRONGkids, 46 (32%) children were at low risk, 76 (53%) at moderate risk and 22 (15%) at high risk for malnutrition. The latter had significantly lower Height for Age values (mean SD value -1.07 ± 2.08; p = 0.008) and BMI values (mean SD-values -0.79 ± 2.09; p = 0.0021) in comparison to other groups. However, only 29 children were actually malnourished.
Conclusions:
The STRONGkids is easy to administer. It is highly sensitive but not specific. It may be used as a very preliminary screening tool to be integrated with other clinical data in order to reliably predict the risk of malnutrition.
