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Assessment of malnutrition in hospitalized children: Comparison of STAMP, PYMS and STRONG-Kids screening tools
Elif Mutlu1, Seda Nur Köktürk2, Nursena Ersoy Söke1
1Ankara University, Graduate School of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkiye.
Insights
This study evaluated three pediatric malnutrition screening tools: STAMP, PYMS, and STRONG-Kids. STRONG-Kids and STAMP showed higher sensitivity for malnutrition, while PYMS offered greater specificity in hospitalized children.
Area of Science:
- Pediatric Nutrition
- Clinical Diagnostics
- Public Health
Background:
- Early identification of malnutrition in hospitalized children is crucial for effective nutritional intervention.
- Validated screening tools are essential for accurate risk assessment.
Purpose of the Study:
- To evaluate the diagnostic performance of three pediatric malnutrition screening tools: STAMP, PYMS, and STRONG-Kids.
- To compare the sensitivity and specificity of these tools in identifying chronic and acute malnutrition in hospitalized children.
Main Methods:
- A cross-sectional study included 148 hospitalized children.
- Nutritional risk was assessed using STAMP, PYMS, and STRONG-Kids.
- Anthropometric measurements and z-scores (height-for-age, BMI-for-age, MUAC-for-age) were analyzed.
- Sensitivity, specificity, and ROC curve analysis were performed.
Main Results:
- Chronic malnutrition affected 12.8% and acute malnutrition 15.5% of participants.
- STAMP and STRONG-Kids exhibited the highest sensitivity for chronic malnutrition (84.2%, 84.3%).
- STRONG-Kids showed 100% sensitivity for acute malnutrition and low MUAC z-scores.
- PYMS demonstrated the highest specificity for acute malnutrition and the highest Area Under the Curve (AUC) for acute malnutrition.
Conclusions:
- STAMP and STRONG-Kids are more sensitive for detecting malnutrition risk, while PYMS offers higher specificity.
- The performance of each tool varies depending on the anthropometric indicators used.
- Selecting the appropriate screening tool based on the type of malnutrition and available indicators can enhance early detection and intervention prioritization.
Aim:
Early identification of malnutrition risk in hospitalized children is essential for timely nutritional intervention. This study aims diagnostic performance of three pediatric malnutrition screening tools validated in Turkish: STAMP, PYMS, and STRONG-Kids.
Methods:
In this cross-sectional study, 148 hospitalized children were included. Nutritional risk was evaluated using STAMP, PYMS, and STRONG-Kids screening tools. Anthropometric measurements were performed, and height-for-age, Body Mass Index (BMI)-for-age, and Middle Upper Arm Circumference (MUAC)-for-age z-scores were calculated. The sensitivity and specificity of each tool were assessed in identifying chronic and acute malnutrition. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminative ability of the screening tools.
Results:
Chronic malnutrition was identified in 12.8% of patients and acute malnutrition in 15.5%. STAMP and STRONG-Kids showed the highest sensitivity for detecting chronic malnutrition (84.2% and 84.3%), while PYMS had the highest specificity. STRONG-Kids demonstrated the greatest sensitivity for acute malnutrition and low MUAC z-scores (100.0%). ROC analysis showed that PYMS had the highest Area Under the Curve (AUC) for acute malnutrition, whereas STRONG-Kids had the highest AUC for chronic malnutrition, although all tools demonstrated limited discriminative ability for chronic malnutrition.
Conclusion:
STAMP and STRONG-Kids were more sensitive in detecting malnutrition risk, whereas PYMS showed higher specificity. Tool performance varied according to anthropometric indicators.
Implications To Practice:
In clinical practice, selecting the screening tool according to the targeted malnutrition type and available anthropometric indicators may improve early detection and allow more effective prioritization of nutritional interventions in hospitalized children.
