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STRONGkids nutrition screening tool in pediatrics: An analysis of cutoff points in Brazil
Joice da Silva Castro1, Carolina Araújo Dos Santos1, Carla de Oliveira Barbosa Rosa1
1Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
Insights
The STRONGkids screening tool effectively identifies pediatric nutrition risk in Brazil. A modified cutoff is proposed, classifying 3 points as high risk to better predict prolonged hospital stays.
Area of Science:
- Pediatric Nutrition
- Clinical Assessment
- Healthcare Management
Background:
- The STRONGkids tool is validated for pediatric nutrition screening in hospitals.
- Its original cutoff values require evaluation for applicability in the Brazilian context.
Purpose of the Study:
- To assess the suitability of STRONGkids cutoff values in Brazil.
- To determine STRONGkids' ability to predict malnutrition and extended hospital stays.
Main Methods:
- Cross-sectional study in a Brazilian public hospital pediatric ward.
- STRONGkids used for nutrition risk assessment; malnutrition identified via anthropometric indexes.
- Receiver operating characteristic curves analyzed to evaluate STRONGkids' predictive capacity.
Main Results:
- Included 599 pediatric patients; 83.6% had medium or high nutrition risk.
- STRONGkids uniquely identified patients with longer hospital stays.
- Patients scoring 3 on STRONGkids showed similar hospitalization patterns to those with high risk (4-5 points).
Conclusions:
- For prolonged hospitalization prediction in Brazil, STRONGkids should classify 3 points as high nutrition risk.
- This adjustment enhances the tool's utility in the Brazilian pediatric population.
- The findings support optimizing STRONGkids for local healthcare needs.
Background:
Studies have indicated the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) as a method of pediatric nutrition screening with good validity in the hospital setting. However, we need to analyze whether the cutoff values originally proposed are suitable for use in Brazil.
Methods:
A cross-sectional study was performed in patients admitted to the pediatric ward of a public hospital. STRONGkids was used to assess nutrition risk (low risk, 0 points; moderate risk, 1-3 points; and high risk, 4-5 points). The indexes weight/height or body mass index/age were used to indicate acute malnutrition, and length or height/age was used to indicate chronic malnutrition. Receiver operating characteristic curves were constructed and the areas under the curve were calculated, with respective 95% confidence intervals, to assess the ability of STRONGkids to predict malnutrition and longer hospital stay.
Results:
The study included 599 patients, with a median age of 2.6 years. The frequency of nutrition risk (medium or high) was 83.6%. In comparison with anthropometric indexes, STRONGkids was the only scoring system with the discriminatory capacity to identify patients with longer hospital stays. The comparative analysis of the means of hospital stay according to STRONGkids showed that patients with a score equal to 3 behaved similarly to those classified as high nutrition risk (4-5 points).
Conclusions:
Considering the best cutoff point to predict prolonged hospitalization, STRONGkids used in Brazil should consider patients with 3 points as having high nutrition risk, as well those scoring 4 and 5.
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