Abstract
Nutritional risk screening (NRS) is not yet established in many clinical settings. This study aimed to evaluate the efficacy of two NRS tools; the Paediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), compared to the global dietitians’ clinical judgment. The goal of this study was also to estimate the prevalence of nutritional risk in Greek paediatric patients. Overall, 1506 children, 1–16 years, from paediatric and surgical wards of two Greek hospitals were included. NRS was performed using PYMS and STAMP based either on World Health Organization (WHOGC) or Hellenic growth charts (HGC). The first 907 children were also referred to dietitians who categorized children in low, medium and high nutritional risk according to their global clinical judgment. PYMS, either based on WHOGC or HGC, showed better agreement with dietitians’ feedback (kPYMS_WHO = 0.47; 95%CI: 0.41–0.52, kPYMS_HGC = 0.48; 95%CI: 0.43–0.53) compared to STAMP (kSTAMP_WHO = 0.28; 95%CI: 0.23–0.33, kSTAMP_HGC = 0.26; 95%CI: 0.21–0.32). PYMS also showed the best diagnostic accuracy compared to STAMP in paediatrics and surgical wards separately. Moreover, the PYMS showed similar sensitivity to the STAMP (WHOGC: 82% vs. 84.4%), but a higher positive predictive value (WHOGC: 58.2 vs. 38.7). Using PYMS, high and medium malnutrition risk was observed at 14.9%, and 13.1% of children, respectively. Almost 28% of hospitalised children were at nutritional risk. Children in hospitals should be screened with effective and feasible NRS tools such as PYMS.
Highlights
Hospitalised children are at higher risk of developing malnutrition, especially disease associated malnutrition [1,2]
The first 907 enrolled in the study were sent for nutritional risk assessment by a hospital dietitian
Paediatric Yorkhill Malnutrition Score (PYMS) superiority was independent of the growth charts used in the present study (i.e., WHOGC or Hellenic growth charts (HGC)) as well as the wards implemented
Summary
Hospitalised children are at higher risk of developing malnutrition, especially disease associated malnutrition [1,2]. According to ESPEN (European Society of Parenteral and Enteral Nutrition) terminology, malnutrition is synonym to undernutrition and several aetiology-based types of malnutrition exist, such as disease-related malnutrition, which is a specific type of malnutrition, caused by a concomitant disease with or without inflammation [3]. Disease-related malnutrition in children is the consequence of a complex interplay of various etiological factors, including reduced food intake due to anorexia, feeding difficulties or the effects of medications or due to the hyper metabolic state caused by the underlying disease per se [5,6,7]. Based on the opinions of health care professionals who routinely assess and treat children with disease-related malnutrition. Disease-related malnutrition of hospitalised children remains a serious problem that is often unrecognized or underestimated by paediatricians and other allied health care professionals [6,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
