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Modified STRONGkids outperforms PYMS for WHO-defined malnutrition: a screening-to-action pathway for pediatric wards

Hong Chen1, Yu Zhang1, Hongwei Han1

  • 1Department of Pediatrics, Wenzhou People's Hospital, Wenzhou, Zhejiang, China.

Frontiers in Pediatrics
|March 2, 2026
PubMed

Insights

Hospitalized children with digestive diseases and infants under one year old face higher malnutrition risks. The modified STRONGkids tool is more effective than PYMS for identifying at-risk children.

Area of Science:

  • Pediatric Nutrition
  • Clinical Assessment
  • Malnutrition Screening

Background:

  • Nutritional status is crucial for hospitalized children's outcomes.
  • Early identification of malnutrition risk is essential for timely intervention.
  • Existing screening tools require evaluation for clinical utility.

Purpose of the Study:

  • To assess the nutritional status of hospitalized children.
  • To evaluate the clinical application of modified STRONGkids and PYMS screening tools.
  • To compare the effectiveness of these tools in identifying malnutrition risk.

Main Methods:

  • Nutritional risk screening of 302 hospitalized children using modified STRONGkids and PYMS tools.
  • Analysis of clinical outcomes and biochemical indicators based on nutritional status.
  • Comparison of screening tool performance (sensitivity, accuracy).

Main Results:

  • Nearly 50% of children were identified as borderline malnourished or malnourished.
  • Digestive system diseases and age under 1 year were associated with significantly higher malnutrition risk.
  • Modified STRONGkids showed higher sensitivity and accuracy than PYMS in identifying malnutrition risk.

Conclusions:

  • Children with digestive diseases and infants are a high-risk group for malnutrition.
  • Both modified STRONGkids and PYMS effectively identify at-risk children.
  • The modified STRONGkids tool demonstrates superior clinical application for malnutrition screening in pediatric inpatients.
Abstract

Keywords:
PYMSSTRONGkidsdigestive system diseasesnutritionalnutritional risk screening

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