Assessment Of Malnutrition Research Articles

Comparative Assessment of Fetal Malnutrition Using the Clinical Assessment of Nutritional Score and Anthropometry Among Newborns Delivered at Debre Markos Comprehensive Specialized Hospital, Ethiopia

Comparative Assessment of Fetal Malnutrition Using the Clinical Assessment of Nutritional Score and Anthropometry Among Newborns Delivered at Debre Markos Comprehensive Specialized Hospital, Ethiopia

The Validity of the Original and the Saudi-Modified Screening Tools for the Assessment of Malnutrition in Pediatrics: A Cross-Sectional Study.

Background: Screening for malnutrition among hospitalized children is essential, and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) is a validated tool for this purpose. The study aimed to modify STAMP for a Saudi context and assess the sensitivity and specificity of both the original and modified tools. Method: A cross-sectional study was conducted among 307 hospitalized children, where both the original and Saudi-modified STAMP were applied. Anthropometric measurements were also recorded, and statistical analysis using SPSS and validity parameters was used to assess the tools' validity. Results: The Saudi-modified STAMP identified a higher percentage of children at high risk of malnutrition compared to the original STAMP (91.6% vs. 62.9%). The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and agreement of the Saudi-modified STAMP compared to the original were 94.3%, 13.2%, 64.8%, 57.7%, 0.654, and 0.089, respectively. Conclusions: The Saudi-modified STAMP showed excellent sensitivity and varied negative predictive value, indicating its potential effectiveness in screening for the risk of malnutrition among hospitalized children compared to the original STAMP.

Assessment of sarcopenia and malnutrition in hospitalised non-critically ill patients using multivariate assessment tools: A multicentric study

Assessment of sarcopenia and malnutrition in hospitalised non-critically ill patients using multivariate assessment tools: A multicentric study

Utility of mid-upper arm circumference in pediatric malnutrition: An Australasian Society of Parenteral and Enteral Nutrition consensus statement using the Delphi method.

Mid-upper arm circumference (MUAC) is a simple anthropometric tool used to screen for childhood undernutrition in humanitarian settings or low-income and middle-income countries. However, there is conflicting evidence and a lack of consensus with regard to its diagnostic use in clinical settings or population groups beyond this context. In 2023, a project officer was appointed by the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN) to lead the development of a consensus review into the use of MUAC in the pediatric clinical setting. An AuSPEN appointed multidisciplinary group of informed clinicians used the Delphi method to critically appraise the evidence and develop a series of consensus statements. Delphi surveys were anonymous and distributed electronically. Members were asked to rate their level of agreement with each consensus statement using a 5-point Likert scale. A priori definition of consensus was established as ≥80% responses "agree" or "strongly agree." Three Delphi rounds were required to reach consensus. A total of 18 consensus statements, including rationale, were developed across the topics 'assessment and diagnosis', 'screening and monitoring' and 'clinical settings'. An evidence-based, region-specific consensus approach to the use of MUAC in pediatric malnutrition is a valuable tool for clinicians. MUAC is a straightforward, non-invasive and cost-effective tool, and may provide an advantage over traditional anthropometric tools in some clinical settings. There are limitations to the utility of MUAC and this consensus paper provides an empirical summary of advantages and limitations as they apply to the screening, assessment, diagnosis, and monitoring of pediatric malnutrition.

Morphofunctional assessment of disease-related malnutrition: "Conceptualization, expert validation, scientific manual, implementation in routine clinical practice (AnyVIDA study), and analysis of future research lines"

Morphofunctional assessment of disease-related malnutrition: "Conceptualization, expert validation, scientific manual, implementation in routine clinical practice (AnyVIDA study), and analysis of future research lines"

The validity of the original and Saudi-modified screening tools for the assessment of malnutrition in pediatrics (STAMP): A cross-sectional study

The validity of the original and Saudi-modified screening tools for the assessment of malnutrition in pediatrics (STAMP): A cross-sectional study

Study of malnutrition in patients with idiopathic pulmonary fibrosis

Background Although the interest in Idiopathic Pulmonary Fibrosis (IPF) has increased in recent years due to the appearance of new therapies however the interest has focused on pulmonary involvement with little concern for systemic manifestations such as the nutritional status abnormalities. Thus, our study assessed the malnutrition prevalence in patients with IPF and the best indicators for the assessment of malnutrition among them. Patients and methods This work was conducted on 110 stable IPF patients who attended the outpatient clinic of Ain Shams University Hospitals from October 2020 to July 2021. Data about the detailed history and nutritional assessment was collected. Results 22.7% and 20.9% were malnourished according to the definition of fat-free mass index (FFMI) and body mass index (BMI), respectively. Most malnourished patients according to low FFMI were female; not using PPI was a significant independent predictors of malnutrition. There was a statistically significant relation between low FFMI and low serum albumin, hemoglobin, and oxygen saturation. Our findings also revealed that measuring BMI and being less than or equal to 22.1 kg/m2 and mid-arm circumference (MAC) less than or equal 28.5 cm is significantly related to low free fat mass index (malnutrition) and increases that risk by 31.63 folds. Conclusion Nearly one-quarter of IPF patients were malnourished and it was found that measuring BMI less than or equal to 22.1 kg/m2 together with MAC less than or equal to 28.5 cm can predict low FFMI and that can be used in our clinical approach.

The role of malnutrition assessment tools in estimating postoperative outcomes after upper gastrointestinal cancer surgery: A bi-center cohort study

The role of malnutrition assessment tools in estimating postoperative outcomes after upper gastrointestinal cancer surgery: A bi-center cohort study

Using 3D facial information to predict malnutrition and consequent complications.

Phase angle (PhA) correlates with body composition and could predict the nutrition status of patients and disease prognosis. We aimed to explore the feasibility of predicting PhA-diagnosed malnutrition using facial image information based on deep learning (DL). From August 2021 to April 2022, inpatients were enrolled from surgery, gastroenterology, and oncology departments in a tertiary hospital. Subjective global assessment was used as the gold standard of malnutrition diagnosis. The highest Youden index value was selected as the PhA cutoff point. We developed a multimodal DL framework to automatically analyze the three-dimensional (3D) facial data and accurately determine patients' PhA categories. The framework was trained and validated using a cross-validation approach and tested on an independent dataset. Four hundred eighty-two patients were included in the final dataset, including 176 with malnourishment. In male patients, the PhA value with the highest Youden index was 5.55°, and the area under the receiver operating characteristic curve (AUC) = 0.68; in female patients, the PhA value with the highest Youden index was 4.88°, and AUC = 0.69. Inpatients with low PhA had higher incidence of infectious complications during the hospital stay (P = 0.003). The DL model trained with 4096 points extracted from 3D facial data had the best performance. The algorithm showed fair performance in predicting PhA, with an AUC of 0.77 and an accuracy of 0.74. Predicting the PhA of inpatients from facial images is feasible and can be used for malnutrition assessment and prognostic prediction.

Nutritional assessment in the HIV-infected older population receiving antiretroviral therapy.

Malnutrition is a pronounced public health issue which often seems underestimated in the older people living with HIV (PLWH) virus infection. PLWH are highly vulnerable to nutritional problems resulting from agingrelated deterioration, disease itself, and adverse effects of antiretroviral therapy (ART). The comprehensive nutritional assessments are necessary to perform routinely in this population to monitor and provide appropriate interventions to reduce comorbid conditions. In this review, we focus on the untoward impacts of malnutrition and nutritional assessments on the morbidity and mortality in the older PLWH. Some predictive factors of nutritional status in this group of patients are discussed. We propose the important components for nutrition assessment tool for older PLWH on ART. Highlighted issue is the need for developing uniform standardized tools for the early diagnosis of malnutrition in this population. Applications of the nutritional assessments, proper nutritional interventions, and regular monitoring of nutritional status in older PLWH liv-ing in every clinical setting may help the patients get better well-being.

The effect of socioeconomic factors on malnutrition in Syrian children aged 0–6 years living in Turkey: a cross-sectional study

BackgroundThis study was conducted to examine the prevalence of malnutrition in Syrian immigrant children living in Turkey.MethodsThe study was carried out in the city of Mardin, which is one of the cities with a high Syrian immigrant population in Turkey. Height, body weight and BMI values were recorded to determine the malnutrition status of the children. Z-scores of children were calculated using the malnutrition assessment WHOAntro program.ResultsThe data show that 30.5% of Syrian children between the ages of 0 and 6 months are male, making up 55.8% of the total, and that 55.3% do not follow a regular breakfast schedule. The percentages of body weight for height, height for age, and BMI for age of Syrian children with a score between − 2 and + 2 SD Number were (89.3%), (74.3%), and (79.3%), respectively. Girls are more likely than boys to experience stunting and low body weight in the context of Syrian children (Stunting OR: 0.855(0.761–1.403), Underweight OR: 0.705(0.609-1,208)). Additionally, there is a link between levels of stunting and underweight and elements like the mother’s educational level and the family’s income. Contrary to the situation of adequate nutrition, it was discovered that the likelihood of stunting and low body weight in children increased by 0.809 and 1.039 times, respectively, when access to an adequate food supply was not available within the family (p < 0.05).Conclusions According to the results of the study, gender, family income, mother’s education level and access to food affected the severity of malnutrition in children. Migration is an imporatnt factor affecting children’s health. In this study malnutrition was found high im immigrant children. Programs should be developed to monitor the growth and development of disadvantaged children and to support their nutrition.

Assessment of Chronic Malnutrition and Its Correlation With Oral Health Status in Children Aged Three to Six Years in Jabalpur District, India: An Epidemiological Study.

This study aims to examine the correlation of chronic malnutrition with the oral health status of children aged three to six years. A total of 400 children were selected and divided into four groups based on z-scores. For evaluation of oral health status, teeth were examined for dental caries using the decayed, missing, and filled permanent teeth (DMFT) scores. Salivary samples were collected to measure salivary flow rate (SFR), pH, and salivary buffering capacity (SBC). Teeth were also visualized to detect the presence or absence of enamel hypoplasia. The data obtained was statistically analyzed (p<0.05). A total of 400 children participated and were also categorized into mild, moderate, and severe obesity according to the z-scores. The mean DMFT scores among adequately nourished children were 2.4086; with severely malnourished and severely obese children, the mean values were found to be 1.0652 and 1.4286, respectively. The mean SFR among children with adequate nutrition was 1.0366, and the mean flow rate among children with severe malnutrition and obesity was 0.5348 and 0.4036, respectively. The mean salivary pH among children with adequate nutrition was 7.1295, and the mean values for participants with severe malnutrition and severe obesity were found to be 6.4772 and 7.6521, respectively. The mean SBC among children with adequate nutrition was found to be 4.4861; for severely malnourished children and those with severe obesity, the values were 3.2472 and 2.8332, respectively. There was an absence of enamel hypoplasia in children with adequate nutrition, whereas a total of five participants with severe malnutrition and three children with severe obesity were found to have hypoplastic lesions, respectively. Malnutrition exerts a negative impact on the overall oral health of children. It is critical to diagnose the effects of malnutrition on children's oral environments in order to provide appropriate treatment and enhance their quality of life.

Identifying Malnutrition Risk in the Elderly: A Single- and Multi-Parameter Approach.

Malnutrition is a significant concern affecting the elderly, necessitating a complex assessment. This study aims to deepen the understanding of factors associated with the assessment of malnutrition in the elderly by comparing single- and multi-parameter approaches. In this cross-sectional study, 154 individuals underwent a comprehensive geriatric assessment (CGA). Malnutrition risk was determined using the mini nutritional assessment (MNA). Additional factors assessed included sarcopenia, polypharmacy, depression, appetite, handgrip strength, and gait speed. Phase angle (PA) and body composition were measured using bioelectrical impedance analysis (BIA). The MNA identified a malnutrition risk in 36.8% of individuals. The geriatric depression scale (GDS) and PA demonstrated moderate effectiveness in assessing malnutrition risk, with AUC values of 0.69 (95% CI: 0.60-0.78) and 0.62 (95% CI: 0.54-0.72), respectively. A logistic regression model incorporating handgrip strength, skeletal muscle mass, sarcopenia, osteoporosis, depression, specific antidepressant use, mobility, appetite, and smoking achieved superior performance in predicting malnutrition risk, with an AUC of 0.84 (95% CI: 0.77-0.91). In conclusion, this study demonstrates that integrating multiple parameters into a composite model provides a more accurate and comprehensive assessment of malnutrition risk in elderly adults.

Effects of malnutrition on disease severity and adverse outcomes in idiopathic pulmonary arterial hypertension: a retrospective cohort study

BackgroundMalnutrition is common in patients with chronic cardiovascular disease and is associated with significantly higher all-cause mortality. Approximately one-third of patients with heart failure are malnourished. However, the relationship between malnutrition and idiopathic pulmonary arterial hypertension (IPAH) remains unclear. This study aimed to clarify the prognostic value of malnutrition in patients with IPAH.MethodsA total of 432 consecutive participants with IPAH were included in this study between March 2013 and August 2021. Three common malnutrition assessment tools, including the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were used to evaluate the nutritional status of patients with IPAH. The relationships between the malnutrition tools and long-term adverse outcomes were determined using restricted cubic splines and multivariate Cox regression models.ResultsDuring a mean follow-up of 3.1 years, 158 participants experienced clinical worsening or all-cause death. Patients were stratified into the low-, intermediate- and high-risk groups based on the European Society of Cardiology (ESC) risk stratification, and the PNI (55.9 ± 5.7 vs. 54.4 ± 7.2 vs. 51.1 ± 7.1, P = 0.005) and CONUT score (2.1 ± 0.9 vs. 2.5 ± 1.2 vs. 3.3 ± 1.1, P < 0.001) identified these patient groups better than the GNRI. All three malnutrition tools were associated with well-validated variables that reflected IPAH severity, such as the World Health Organization functional class, 6-min walk distance, and N-terminal pro-brain natriuretic peptide level. The CONUT score exhibited better predictive ability than both the GNRI (ΔAUC = 0.059, P < 0.001) and PNI (ΔAUC = 0.095, P < 0.001) for adverse outcomes and significantly improved reclassification and discrimination beyond the ESC risk score. Multivariable Cox regression analysis indicated that only the CONUT score (hazard ratio = 1.363, 95% confidence interval 1.147, 1.619 per 1.0-standard deviation increment, P < 0.001) independently predicted adverse outcomes.ConclusionsThe malnutrition status was associated with disease severity in patients with IPAH. The CONUT score provided additional information regarding the risk of clinically worsening events, making it a meaningful risk stratification tool for these patients.

Exploring the Influence of Concurrent Nutritional Therapy on Children with Spinal Muscular Atrophy Receiving Nusinersen Treatment.

Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients' dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale-Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from -0.95 to -0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to -0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ -2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.

Determination of Nutritional Status, Biochemical Parameters and Stroke Severity in Acute Ischemic Stroke Patients: A Cross-Sectional Study

Nutritional problems and nutritional deficiencies resulting from impaired consciousness, dysphagia, fatique and perceptual disturbances can frequently be observed in ischemic stroke patients after acute stroke. Weight loss in patients with dysphagia can often cause malnutrition. This study was conducted to determine the severity of stroke and nutritional status in acute ischemic stroke patients and to screen the risk of malnutrition. In this study, the nutritional status of ischemic stroke patients was evaluated with NRI and NRS 2002 and some biochemical parameters were examined from the patient file. All patients had moderate to severe ischaemic stroke (NIHSS: 9.9±2.51) and the majority were at risk of malnutrition according to NRS 2002 (92.3% vs. 93.8%, p=0.55). The majority of acute ischaemic stroke patients were found to be moderately malnourished (moderate risk, 52.4%), followed by mild malnutrition risk (23.8%) according to NRI risk score. Patients had low levels of albumin (3.1±0.58 g/dL), prealbumin (13.0±5.40 mg/dL), and hemoglobin (11.6±2.34 g/dL). Total cholesterol (188.7±35.43), triglycerides (134.2±57.43 mg/dL), and LDL (118.7±31.42 mg/dL) were within normal limits, while HbA1c (6.8±2.40) and fasting plasma glucose (150.0±69.00 mg/dL) levels were high. As a result, this study highlights the importance of malnutrition assessment and monitoring of biochemical parameters.

GLIM Achieves Best Diagnostic Performance in Non-Cancer Patients with Low BMI: A Hierarchical Bayesian Latent-Class Meta-Analysis.

Global Leadership Initiative on Malnutrition (GLIM) and Patient-Generated Subjective Global Assessment (PG-SGA) are commonly used nutrition assessment tools, whose performance does not reach a consensus due to different and imperfect reference standards. This study aimed to evaluate and compare the diagnostic accuracy of GLIM and PG-SGA, using a hierarchical Bayesian latent class model, in the absence of a gold standard. A systematic search was undertaken in PubMed, Embase, and Web of Science from inception to October 2022. Diagnostic test studies comparing (1) the GLIM and/or (2) PG-SGA with "semi-gold" standard assessment tools for malnutrition were included. Two authors independently extracted data on sensitivity, specificity, and other key characteristics. The methodological quality of each included study was appraised according to the criteria in the Quality Assessment of Diagnostic Accuracy Studies-2. A total of 45 studies, comprising 20 876 individuals evaluated for GLIM and 11 575 for PG-SGA, were included. The pooled sensitivity was 0.833 (95% CI 0.744 to 0.896) for GLIM and 0.874 (0.797 to 0.925) for PG-SGA, while the pooled specificity was 0.837 (0.780 to 0.882) for GLIM and 0.778 (0.707 to 0.836) for PG-SGA. GLIM showed slightly better performance than PG-SGA, with a higher diagnostic odds ratio (25.791 vs 24.396). The diagnostic performance of GLIM was most effective in non-cancer patients with an average body mass index (BMI) of <24kg/m2, followed by non-cancer patients with an average age of ≥60 years. PG-SGA was most powerful in cancer patients with an average age of <60 years, followed by cancer patients with an average BMI of <24 kg/m2. Both GLIM and PG-SGA had moderately high diagnostic capabilities. GLIM was most effective in non-cancer patients with a low BMI, while PG-SGA was more applicable in cancer patients. PROSPERO registration No. CRD42022380409.

Nutrition Screening for 2-5 Years Old Children by Screening Tool for the Assessment of Malnutrition in Paediatrics in Outpatient Setting

Abstract Introduction and Aim of the work Malnutrition is the primary causative factor of pediatric mortality and repeated hospitalization. The aim of this study is to highlight the role of nutrition screening in identifying those at risk of malnutrition who may benefit from nutritional interventions and test whether the nutritional supplements are essential during nutritional rehabilitation. Patients and methods Screening for malnutrition of 3640 children at the outpatient clinic of Ain Shams Pediatric hospital by Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) followed by assessing 100 patients at high risk of malnutrition by anthropometric measurements, then BMI and z scores were computed. Oral nutritional supplement was advised in the rehabilitation program only in group A. Nutritional response testing was performed by reassessment at three and six months. Results The prevalence of underweight, stunting and wasting were 5.9%, 15.6%, and 9.4% respectively. As per STAMP, 14.7% were found to be nutritionally at low risk, 7.3% at intermediate risk, and 5.1% at high risk compared to 72.83% without risk for malnutrition. STAMP showed a significant increase in patients at low risk and decrease in patients at high risk through follow up in both groups with better percentages in group A which coincides with improvement in anthropometric indices. Conclusion STAMP is a sensitive, quick, and easy to use nutritional screening tool with a crucial role in identifying nutrition risk at outpatient services which can lead to implementing prompt nutritional rehabilitation. Tailored nutritional plans can accomplish good response and adding a nutritional supplement to the dietary plan ensures earlier goal achievement.

Comparison of Malnutrition Assessment Tools for Identification of Malnutrition in Community-Dwelling Older Adults With Dementia

Comparison of Malnutrition Assessment Tools for Identification of Malnutrition in Community-Dwelling Older Adults With Dementia

Status Epilepticus in Children at a Tertiary Care Center in India: Etiology, Preventable Risk Factors, and Short-Term Outcome

Abstract Introduction Status epilepticus (SE) is a common neurological emergency in children. Recent guidelines suggest initiating treatment after 5 minutes of seizure activity. Objective This study analyzes the clinical, laboratory parameters, and treatment outcomes of children with SE to identify preventable risk factors. Materials and Methods Prospective observational study of 150 children. They were evaluated for relevant history, clinical features, laboratory investigations, treatment, course, and outcome. Results The risk factors that had an impact on outcome in children with SE were identified as red flag signs on initial pediatric advanced life support (PALS) assessment, malnutrition, abnormal head circumference and number of seizures before child presented to hospital. The strongest predictor of outcome was stable status of children on initial PALS assessment (odds ratio = 20.174 [1.117, 364.393], p = 0.042). Presence of abnormal head size was 86% less likely to have favorable outcome and if the child had lesser number of seizures before child presented to hospital (single), it was 3.7 times likely that it would yield a favorable outcome. Conclusion Aggressive treatment of seizures, identification of red flag signs on initial PALS assessment, identification and treatment of malnutrition, anemia, hypocalcemia, and sodium derangements, strengthening vaccination to prevent central nervous system infections, and early intervention for developmental delay, can all help to combat morbidity and mortality in children with SE.