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Comparison of four nutritional screening tools for Korean hospitalized children
1Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University College of Medicine, Yangsan 50612, Korea.
Insights
Four nutritional screening tools showed varied results in identifying malnutrition risk in hospitalized children in Asia. Proper tool selection is crucial for accurate pediatric malnutrition assessment.
Area of Science:
- Pediatric Nutrition
- Clinical Nutrition
- Hospital Malnutrition
Background:
- Nutritional screening tools are vital for early detection of malnutrition in hospitalized children.
- Existing tools lack validation in Asian pediatric populations.
- This study addresses the need for validated nutritional assessment in this demographic.
Purpose of the Study:
- To compare the effectiveness of four nutritional screening tools in identifying malnutrition risk in newly hospitalized children.
- To evaluate the performance of the pediatric nutritional risk score (PNRS), screening tool for the assessment of malnutrition in pediatrics (STAMP), paediatric Yorkhill malnutrition score (PYMS), and screening tools for risk of nutritional status and growth (STRONGkids).
Main Methods:
- A retrospective review of medical records for 559 newly admitted pediatric patients from June 2016 to May 2017.
- Collection of demographic, clinical, and anthropometric data at admission.
- Assessment of nutritional risk using PNRS, STAMP, PYMS, and STRONGkids.
Main Results:
- Prevalence of malnutrition risk varied significantly across the four tools.
- Moderate agreement was observed between PNRS and STRONGkids (kappa=0.566), and STAMP and PYMS (kappa=0.495).
- PYMS and STAMP demonstrated high sensitivity for detecting wasting (87.8% and 77.6%, respectively).
Conclusions:
- Nutritional screening tools yield considerably different results in assessing pediatric malnutrition risk.
- Pediatric patients face malnutrition risks upon admission and during hospitalization.
- The choice of screening tool should be tailored to the specific hospital context and patient population.
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 ± 5.5 years) 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.
