Abstract
ABSTRACTObjective: Verify the association between anthropometric indicators and the Subjective Global Assessment of Nutritional Status (SGA) and the Screening of Risk for Nutritional Status and Growth (STRONGkids) scales. Methods: A cross-sectional study with patients from 0 to 18 years admitted in the Hospital das Clínicas, Goiânia (GO), between August and November 2015. Children and adolescents admitted in up to 48 hours were included. Patients who required specific instruments for assessing their nutritional status and those hospitalized in Intensive Care were excluded. Identification and anthropometric data was collected and applied to the SGA and STRONGkids. We performed an analysis comparing proportions and did an agreement assessment, where p<0.05 was significant.Results: 71 patients were evaluated, of whom 9.6% had low or very low birth weight/age, 9.7% had thinness or accentuated thinness according to the weight/height index, 16.9% had a height impairment, 7% were thin according to the body mass index/age, and 32.4% were malnourished with regard to arm muscle circumference. The STRONGkids detected that 69% of the sample had a moderate or high nutritional risk. According to the SGA, malnutrition prevalence was 38.1%. There was an association between the SGA and body mass index/age (p=0.022), height/age (p<0.001) and arm muscle circumference (p=0.014). There was no association between the STRONGkids and anthropometric indicators. A correlation was found between: high nutritional risk versus severe malnutrition and low nutritional risk x the well-nourished (p<0.001), but the agreement was weak (k=0.255). Conclusions: It is recommended to use the STRONGkids as a screening instrument because it has a higher sensitivity for diagnosing patients with a nutritional risk. The SGA should be applied to nutritional assessment due to its association with anthropometry.
Highlights
The global prevalence of primary malnutrition has decreased in recent decades
When assessed by anthropometric indicators: 9.6% had low or very low birth weight/age; 9.7% thinness or thinness accen‐ tuated by weight/height index; 16.9% had a height impairment; 7% were underweight by body mass index (BMI)/A; and 32.4% were malnour‐ ished by arm muscle circumference (AMC) (Table 1)
Through STRONGkids, moderate and high nutritional risk was diagnosed in 69% of the sam‐ ple
Summary
The global prevalence of primary malnutrition has decreased in recent decades. It is unclear whether the prevalence of secondary malnutrition has decreased.[1] Children with complex diseases admitted at children’s hospitals share differ‐ ent mechanisms of secondary malnutrition, which are deter‐ mined by the underlying disease, such as the reduction of food intake, poor absorption and increased energy expenditure, among others. Malnutrition is associated with a bad prognosis in hospi‐ talized patients, and it is possible to identify increased risk of infections, increased loss of muscle mass, difficulty in wound healing, longer hospital stays and increased morbidity and mor‐ tality. Some additional consequences are added, such as growth and cognitive development impairment as well as low performance at school.[3,4,5] In this context, it is import‐ ant to identify children with the greatest nutritional risk early on, as it enables physicians/clinicians to provide guidelines for an intervention capable of preventing the worsening of the patient’s nutritional status, or for promoting their recovery.[2, 6,7,8]
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