Screening Tool For Assessment Of Malnutrition In Pediatrics Research Articles

Association between Nutritional Status of a Child Using Screening Tool for Assessment of Malnutrition in Paediatrics and Clinical Outcomes in Inpatients at a Tertiary Care Hospital Setting in Eastern Nepal

Introduction: Malnutrition in children has health and physical consequences resulting in delayed physical growth and motor development, behavioral and social problems as well as susceptibility to contracting diseases.The Screening Tool for Assessment of Malnutrition in Pediatrics (STAMP) is a specially constructed tool that uses anthropometric measurements, body composition, and patient's clinical status to predict the risk of malnutrition for inpatients at admission. There is no agreement on the ideal screening tool or scales for detecting and determining the level of malnutrition in pediatric inpatients. Various studies in the pediatric population have analyzed the association of malnutrition during hospitalization with patient outcomes, but few have analyzed whether the STAMP tool in particular could be used to predict length of hospital stay and disease severity in these patients. Objectives: We studied the use of STAMP screening tools to assess the risk of malnutrition in inpatients by including a nutritional screening in the admission process and analyze the association between the risk of malnutrition and patient outcomes (length of hospital stay and severity of disease). Methodology: We conducted a prospective single-center study between May to July 2021 at a tertiary care hospital. All patients admitted to the pediatric ward aged 1 month to 15 years with a length of stay of at least 24 hours were included into the study. Data were collected about clinical, anthropometric and demographic variables for each patient including STAMP grading, length of hospital stay and severity of disease. Results: Our study suggests comparable demographic and other patient-related variables in the three categories (mild, moderate and severe) of STAMP grading (p-value >0.05). STAMP grading was not significantly associated with both length of hospital stay and severity of disease. Conclusion: The use of STAMP as a malnutrition screening tool for pediatric inpatients is not significantly associated with length of stay or severity of disease.

Nutrition risk profile of 62 408 inpatients based on electronic health records in a tertiary children's hospital

ObjectivesThis study aimed to evaluate the nutrition risk profile of hospitalized children with electronic health record–based nutrition risk screening. Additionally, this study analyzed the association between high nutrition risk and clinical outcomes. MethodsChildren discharged from Shanghai Children's Medical Center between 2017 and 2018 were enrolled and nutritionally screened. Nutrition risk scores using the Screening Tool for Assessment of Malnutrition in Pediatrics (STAMP), length of stay (LOS), and costs of hospitalization were recorded. Enrolled patients were categorized into two groups: the low and medium nutrition risk (LMNR) group, with scores ranging from 0 to 3, and the high nutrition risk (HNR) group, with scores ≥4. ResultsOut of 62 408 subjects, 17.4% were at HNR. Patients with congenital heart diseases (83.9%), hematology-oncology diseases (26.0%) and gastroenterological diseases (21.4%) were affected most. Infants had the highest HNR rates (35.5%) of any age group. Surgical patients (20.7%) had a higher rate of HNR than non-surgical patients (9.5%). The HNR group had longer LOS (10.0 d versus 3.0 d, P < 0.001), higher total hospital costs (53 680.1 Chinese yuan [CNY] versus 8810.1 CNY, P < 0.001), and higher costs of antibiotics (441.0 CNY versus 0.0 CNY, P < 0.001) compared to the LMNR group. As STAMP score values increased, growing LOS and costs of hospitalization, medications, and antibiotics were observed. ConclusionsA high prevalence of HNR was found in patients of Shanghai Children's Medical Center. Surgeries, specific disease, and infancy were important HNR risk factors. HNR scores using STAMP might predict prolonged LOS and higher medical costs.

Nutritional Risk Assessment in Children with Cancer: A Longitudinal Study in North East of Iran

Background Children with cancer are in risk of malnutrition. Nutritional risk assessmentis more importance in developing countries. The aim of present study was to investigate the nutritional risk in admitted children with cancer. Materials and Methods One hundred admitted children newly diagnosed with cancer were studied at the time of admission, after 3 and 6 months.Demographic characteristics and anthropometrics indexes were recorded via standard and calibrated tools. Nutritional risk assessed according to modified Screening Tool for Assessment of Malnutrition in Pediatrics (STAMP).Statistical analysis was performed using SPSS software (version 16.0). Results Of the 100 children 55 patients (55%) were female. The average age was 3.46±3.3 years. Hematologic tumors constituted 73.5% of patient. All patients were in nutritional risk. There was no patient with low nutritional risk during study; 17 patients (17%), 53 patients (56.4%), and 41 patients (43.6%) diagnosed with medium nutritional risk at the time of admission, after 3 and 6 months, respectively; 83 patients (83%), 41 patients (43.6%), and 40 patients (43%) diagnosed with high nutritional risk at the time of admission, after 3 and 6 months, respectively. Difference was significant (p<0.001).After 6 months,weight, height, mid-upper arm circumference (MUAC), and body mass index (BMI) increased compared with the time of admission (p<0.05). Conclusion According to modified STAMP results, all studied patients were in the nutritional risk. Nutritional risk decreased during study. The nutritional risk decreased after 6 months in children newly diagnosed with cancer compared with the time of admission.

Profile and prevalence of malnutrition in children with spinal cord injuries—assessment of the Screening Tool for Assessment of Malnutrition in Paediatrics (STAMP)

Data on the prevalence of malnutrition in paediatric patients with spinal cord injury (SCI) are limited. The present study aimed to establish the risk of (i) under-nutrition by using the Screening Tool for Assessment of Malnutrition in Paediatrics: STAMP (score ≥2) and (ii) over-nutrition by body mass index (BMI) centile (≥91st: overweight; ≥98th: obese). After obtaining informed consent, a standardized questionnaire was used to collect baseline demographic data and nutrition risk score; BMI was measured and routine blood biochemistry was reviewed in every child (>6 months and <18 years) admitted to the SCI centre. Sixty-two children (mean age, 11.4 years; s.d., 4.9; median, 13 years; interquartile range, 7.8-15.6, 39.4% female) with SCI (46.5% tetraplegia, 53.4% complete SCI) were assessed. Prevalence of over-nutrition was high (BMI centile ≥91st, 41.1%; ≥98th, 25.5%). Under-nutrition risk was 47.1% (STAMP ≥2). Only 60% of these 'at risk' patients were referred for further nutritional assessment. Associated phenomena included previous intensive care (55.6 versus 20.8%, P<0.05), mechanical ventilation (58.3 versus 18.2%, P<0.01) and past need for artificial nutrition support (75 versus 12.8%, P<0.01). Both over- and under-nutrition appear common in children with SCI. Our data indicate, furthermore, that children at nutritional risk are under-managed. Future research is needed to complete the validation of the screening tools and to determine how effective intervention can be ensured.