Application of nutritional risk screening in children hospitalized in general surgery department

Abstract

Objective To evaluate the application of nutritional risk screening in children hospitalized in general surgery department, in order to provide the basis for selecting the screening tool. Methods Nutritional risk screening was performed on 123 children hospitalized in the general surgical department by using the Assessment of Malnutrition in Paediatrics(STAMP) and Paediatric Yorkhill Malnutrition Score(PYMS). The malnutrition prevalence based on the World Health Organization (WHO) child growth standards(WHO standards) was evaluated.The data of hospital stay and total hospital expenses were recorded and analyzed. Results By using the STAMP and PYMS, 76.4%(94/123 cases)and 85.4%(105/123 cases) of the patients had low-moderate nutritional risk, 23.6%(29/123 cases) of the patients and 14.6%(18/123 cases) had high nutritional risk, respectively.The malnutrition prevalence was 17.9%(22/123 cases) based on WHO standards.Children with high nutritional risk screened by STAMP, PYMS and malnutrition evaluated by WHO standards had significantly longer hospital stay(days) and higher total hospital expenses(yuan) compared with those in low-moderate nutritional risk or non-malnutrition patients, and the differences were statictically significant(hospital stay: STAMP: M=8.50>7.00, Z=-2.608, P=0.008; PYMS: M=8.00>6.25, Z=-2.761, P=0.006; WHO standards: M=8.25>6.75, Z=-2.812, P=0.005.Total hospital expenses: STAMP: M=4 970.46>2 939.07, Z=-2.913, P=0.004; PYMS: M=5 486.57>3 294.96, Z=-3.024, P=0.002; WHO standards: M=5 515.87>3 170.04, Z=-3.098, P=0.002). According to WHO standards, the sensitivity, specificity, Youden index, positive predictive value and negative predictive value of STAMP and PYMS were 68.2% vs.77.3%, 86.1% vs.99.0%, 54.3% vs.76.3%, 51.7% vs.94.4%, 92.6% vs.95.2% respectively. Conclusion Both STAMP and PYMS can be used for nutritional risk screening in hospitalized children in general surgery department, while sensitivity and specificity of PYMS are better than those of STAMP. Key words: General surgery department; Hospitalized children; Nutritional risk screening