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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Development and validation of a pediatric nutritional screening score (PNSS) for hospitalized children
Lina Lu1,2,3, Xiaomeng Mao2, Jinye Sheng2
1Division of Pediatric Gastroenterology and Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background And Objectives:
There is no evidence on the most effective nutritional screening tool for hospitalized children. The objective of this study was to develop and validate a pediatric nutritional screening tool to assess undernutrition risk upon hospital admission.
Methods And Study Design:
The study had a two-phase prospective observational design. A novel pediatric nutritional screening score (PNSS) was developed and sensitivity, specificity, and reliability were evaluated by comparing with a complete dietetic assessment. Length of hospital stay, weight loss, disease complications, and nutritional support were recorded.
Results:
PNSS consisted of three elements: disease with malnutrition risks, changes in food intake, and anthropometric measurements, with a score of 0-2 for each element. The optimal cut-off score to identify patients (n=96) at risk of undernutrition was two. The agreement between PNSS and the complete dietetic assessment was moderate (κ=0.435, 95% CI=0.373-0.498). Sensitivity and specificity values of PNSS were 82% (95% CI=76%-87%) and 71% (95% CI=67%-74%), respectively. Inter-rater agreement had a κ value of 0.596 (95% CI=0.529-0.664, p<0.001). The percentage of children with undernutrition risk was 44.9%. Children with oncologic, gastrointestinal, and cardiac diseases were most likely to be at risk of undernutrition. The at-risk group was associated significantly with longer length of hospital stay and higher percentage of weight loss compared with the not-at-risk group.
Conclusion:
PNSS is the first nutritional screening tool developed for hospitalized children and validated in a large population of patients in China.
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