Screening Tool For The Assessment Of Malnutrition In Pediatrics Research Articles

The malnutrition screening tool STRONGKIDS performed better than other screening tools for children hospitalised in Egypt.

To compare the accuracy of three different screening tools, namely, the Paediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), and Screening Tool for Risk on Nutritional Status and Growth (STRONGKIDS), in assessing malnutrition risk in hospitalised children. A cross-sectional study was conducted on 300 children aged 6 months to 15 years at Alexandria University Children's Hospital, Egypt. The sensitivity and specificity of each tool were calculated to detect acute and chronic malnutrition, and an agreement test was conducted between the nutritional screening tools. The patients were classified into different nutritional risk groups, and their classification was compared with anthropometric measures and clinical variables, such as the length of hospital stay (LOS). The prevalence of stunting and wasting on admission was found to be 3% and 6.6%, respectively. Children categorised as high-risk on admission had a longer LOS than those at low risk. The agreement test between the STAMP score and STRONGKIDS score on admission showed the most significant agreement, and STRONGKIDS had the best accuracy in detecting acute and chronic malnutrition. The comparison of the three screening tools revealed that STRONGKIDS exhibited the best accuracy in detecting acute and chronic malnutrition.

Evaluation of malnutrition and screening tools in hospitalized children

Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than-2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p<0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p<0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p>0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.

Adaptation in Spanish and validation in Mexico of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP

Background: pediatric malnutrition is one of the main causes of complications in hospitalized children. Nutritional screening at admission is essential. The Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) is a simple, reproducible and easy-to-interpret tool, but it is not validated in Mexico. The objective of the study was to validate and adapt the STAMP nutritional screening tool to the Mexican population. Methods: the validation was carried out in two phases: firstly, the translation and cultural adaptation was carried out; and secondly, a cross-sectional study was performed comparing the STAMP tool with a complete nutritional assessment (CNA). A pediatrician specialized in nutrition performed the CNA with the evaluation of anthropometric, clinical and dietary parameters; later, two nutritionists carried out the same evaluation with the STAMP tool. Finally, the patients were graded as low risk and moderate or severe malnutrition risk. Results: of the 300 patients included in the study, 160 were boys (53.3 %) and 140 were girls (46.7 %), with a mean age of 9.44 ± 5.73 years. The assessments made by with the STAMP tool had a 100 % concordance. Compared with CNA, a kappa index of 0.480 (p < 0.01) was obtained. The STAMP test showed a sensitivity of 92 %, a specificity of 75 %, positive predictive value (PPV) of 45 %, negative predictive value (NPV) of 97 %, RVN of 3,68, and RVN of 0,10. Conclusions: the STAMP screening tool has the necessary elements to objectively assess the risk of malnutrition in Mexican children and is a highly sensitive and specific test. test.

Value of Nutritional Screening Tools Versus Anthropometric Measurements in Evaluating Nutritional Status of Children in a Low/Middle-Income Country.

Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

Nutritional rehabilitation of malnourished children: are nutritional supplements a must?

Objective Malnutrition threatens children worldwide. The objective of the current study was to highlight the role of nutritional screening, evaluate the effectiveness of nutritional intervention program, and whether nutritional supplements have surplus benefit. Patients and methods Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) was used to screen 3640 clinically stable 2–5 years old children recruited from the outpatient clinics, Children’s Hospital, Ain Shams University. A total of 100 patients at high risk of malnutrition were enrolled. Full nutritional assessment was done and according to the distribution of the calories in the daily meal plan, the patients were randomly divided into two groups each comprised 50 patients. Group A received tailored nutritional dietary rehabilitation plan including dietary supplements, while Group B received only dietary advice. Anthropometric measurements, laboratory tests, as well as STAMP scoring were reassessed after the nutritional rehabilitation programs. Results Nutritional screening revealed that 5.14% were at high risk of malnutrition. Both studied groups showed significant improvement in caloric intake and all anthropometric measurements upon nutritional rehabilitation, except for the height z scores. Patients who received nutritional supplements showed significantly better changes regarding weight, BMI, caloric intake, and hemoglobin. Regarding STAMP categories during follow up, Group A had only 6% of the patients still in the high-risk category and 76% were at low risk compared to 14% high risk and only 54% were at low risk in Group B. Conclusions Nutritional screening in pediatric outpatient facilities can lead to implementing prompt nutritional rehabilitation, which can reflect on the patients’ overall health. Tailored nutritional plan can accomplish good response in terms of improvement of caloric intake, anthropometric measurements and laboratory parameters. Adding a nutritional supplement to the dietary plan during nutritional rehabilitation isn’t a must but it ensures superior goal achievement.

ALL-066 Safety and Efficacy of Turmeric in Children With Acute Lymphoblastic Leukemia

Gut microbiota may have a role in regulating the progress of cancer. Curcumin and its metabolites may have various effects on cancer treatments by eliminating intestinal microflora dysbiosis. To assess the safety and efficacy of curcumin in children with acute lymphoblastic leukemia (ALL) and determine whether gut microbiota can be used to predict therapy-related complications. Single-center, open-label prospective randomized controlled clinical trial. Pediatric Hematology Oncology Department, Ain Shams University Hospitals, Cairo, Egypt. All patients underwent detailed clinical assessment and anthropometric measurement. Nutritional assessment was performed using the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and nutrition risk were assigned based on 3 parameters: nutrition implication of the patient's medical diagnoses, recent nutrition intake, and anthropometrics. Complete blood count, total protein, and albumin were gathered. Fecal samples were collected to detect microbiota quantity. A block-randomization scheme was generated by computer software; patients were randomized between curcumin plus the nutritional standard of care (SOC) and the nutritional SOC only, which consisted of a nutrition program through supplementation of a high-caloric, high-protein diet, tailored according to patients' age and sex for both groups. Curcumin 500 mg was supplemented per oral capsule twice daily for 1 month starting at week 1 of the maintenance phase of chemotherapy. Patients were followed up with once weekly during the curcumin supplementation to monitor compliance and adverse events. All assessments were performed at ALL diagnosis, at week 1 of maintenance phase of chemotherapy, and after 1 month of intervention. Thirty pediatric patients with confirmed ALL were recruited from day 0 of presentation and followed over a 12-month period. The majority of patients were under 10 years of age and presented mainly with fever at time of diagnosis. Their initial nutritional assessment showed STAMP scores of mainly 3 and 4. The curcumin showed a safety profile and was tolerated by most patients. The effects of curcumin on microbiota were studied through assessment of the proportions of Lactobacillus and Bifidobacterium in fecal samples, and the results are in the statistical analysis phase. This interim analysis showed a promising role of curcumin as a nutritional supplement in children with ALL.

Agreement between nutritional risk screening tools and anthropometry in hospitalized pediatric patients.

The use of malnutrition screening tools has been recommended to identify the risk of malnutrition among hospitalized children. The aim of this study was to evaluate the association between the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and anthropometric nutritional parameters to identify malnutrition in hospitalized children. Data recorded in the nutrition sector for 672 pediatric patients hospitalized between 2019 and 2020 were used to complete the STRONGkids and STAMP tools. To test for associations, the chi-square test or Fisher-Freeman-Halton Exact Test were employed, accepting a p-value <0.05 as the threshold for significance. To determine agreement, the Kappa coefficient was applied. Patients with a mean age of 5 years and 7 months were classified as at high nutritional risk by STRONGkids and STAMP in 10.1% (n=68) and 24.3% (n=163) of cases, respectively. A significant association (p<0.05) was identified between all parameters studied for both tools. For STRONGkids, the chi-square test were as follows: BMI/Age, 69.707; Height/Age, 37.730; Weight/Age, 72.202; and Weight/Height, 60.595, whereas for STAMP, they were BMI/Age, 79.620; Height/Age, 75.246; Weight/Age, 91.034; and Weight/Height, 57.227. When compared, the two tools showed significant moderate agreement (κ=0.448; p<0.001). STAMP classified a higher percentage of patients as being at high nutritional risk when compared with STRONGkids, and both tools had a significant association when compared with anthropometric parameters. Screening tools are easy to apply and can be used to identify the risk of malnutrition in this population.

Возможности реализации скрининговых методов оценки нутритивного риска у детей с неврологической патологией

Objective. Comparative evaluation and study of the effectiveness of using different nutritional risk screening tools in children with neurological pathology. Patients and methods. This study included 105 children with neurological pathology (epilepsy, cerebral palsy, congenital anomalies of the nervous system), among whom were 50 (47.6%) boys and 55 (52.4%) girls aged 1 to 17 years (7.8 ± 4.9 years). Anthropometric indices were assessed and questionnaires using nutritional risk screening tools were conducted, followed by calculation of their sensitivity and specificity. STRONGkids (Screening Tool Risk on Nutritional Status and Growth), PYMS (Pediatric Yorkhill Malnutrition Score), and STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics) were used. Results. Assessment of anthropometric indices (weight-for-height, BMI-for-age, and height-for-age Z-scores) indicated malnutrition in 5 to 15 children (4.8-14.3%), depending on the evaluation criteria. According to the screening results, all patients were classified as high and medium risk of malnutrition, and 94 (89.5%) children required nutritional care according to STRONGkids, 38 (36.2%) children – according to PYMS, and 104 (99%) children – according to STAMP. The most sensitive screening tool was STAMP with a sensitivity score of 89.5% as compared with STRONGkids and PYMS (21.1% and 31.6%, respectively). Conclusion. The results of this work demonstrate the advantages of the STAMP tool in assessing the nutritional status of children with neurological pathology, given its higher efficacy in this group of patients, and the need for further research to develop practical recommendations. Key words: children, nutrient deficiency, nutritional risk screening tools

Validation of screening tool for the assessment of malnutrition in pediatrics - stamp in a Brazilian hospitalized children population

Rationale: Guidelines recommend the use of malnutrition screening tools to identify risk of malnutrition among the hospitalized children. The aim of this study was evaluating the reliability of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) to determine malnutrition risk of pediatric patients.

Malnutrition in Hospitalised Children-An Evaluation of the Efficacy of Two Nutritional Screening Tools.

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.

Validation of 3-Minute Nutrition Screening-Paediatric (Paediatric 3-MinNS) for Hospitalized Children

Nutrition screening in pediatric hospitals is not a common practice in many countries. This study validated the 3-Minute Nutrition Screening-Paediatric (Paediatric 3-MinNS) with Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), anthropometric measures, biochemical parameters, and dietary assessment. This cross-sectional study included 165 patients aged 2 to 12 years admitted as pediatric patients to the University Malaya Medical Centre. The tool identified 26.1% of patients as being at high risk of malnutrition. The findings suggest that Paediatric 3-MinNS offers a valid and reliable screening tool for early recognition of children at risk of malnutrition.

Nutrition Evaluation Screening Tool: An Easy to Use Screening Tool for Hospitalised Children.

PurposeNutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool.MethodsRetrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool.ResultsThere was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital.ConclusionThe moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.

Use of standardized body composition measurements and malnutrition screening tools to detect malnutrition risk and predict clinical outcomes in children with chronic conditions

Better tools are needed to diagnose and identify children at risk of clinical malnutrition. We aimed to compare body composition (BC) and malnutrition screening tools (MSTs) for detecting malnutrition on admission; and examine their ability to predict adverse clinical outcomes [increased length of stay (LOS) and complications] in complex pediatric patients. This was a prospective study in children 5-18 y old admitted to a tertiary pediatric hospital (n=152). MSTs [Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids)] were completed on admission. Weight, height, and BC [fat mass (FM) and lean mass (LM) by DXA] were measured (n=118). Anthropometry/BC and MSTs were compared with each other and with clinical outcomes. Subjects were significantly shorter with low LM compared to reference data. Depending on the diagnostic criteria used, 3%-17% were classified as malnourished. Agreement between BC/anthropometric parameters and MSTs was poor. STAMP and STRONGkids identified children with low weight, LM, and height. PYMS, and to a lesser degree STRONGkids, identified children with increased LOS, as did LM compared with weight or height. Patients with complications had lower mean±SD LM SD scores (-1.38±1.03 compared with -0.74±1.40, P<0.05). In multivariable models, PYMS high risk and low LM were independent predictors of increased LOS (OR: 3.76; 95% CI: 1.36, 10.35 and OR: 3.69; 95% CI: 1.24, 10.98, respectively). BMI did not predict increased LOS or complications. LM appears better than weight and height for predicting adverse clinical outcomes in this population. BMI was a poor diagnostic parameter. MSTs performed differently in associations to BC/anthropometry and clinical outcomes. PYMS and LM provided complementary information regarding LOS. Studies on specific patient populations may further clarify the use of these tools and measurements.

Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in the Electronic Health Record: A Validation Study.

The impact of malnutrition on pediatric patients in the acute care setting is significant. Hospitalized patients with malnutrition have been shown to have poor clinical outcomes. Nutrition screening is the first critical step in identifying and treating malnutrition. Although several pediatric nutrition screening tools exist, none incorporate both electronic health record (EHR) compatibility and the recommended indicators of pediatric malnutrition, a gap recently identified in a systematic review by the Academy of Nutrition and Dietetics. The aim of this study was to prove the validity of a new version of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), EHR-STAMP, modified for incorporation into the EHR and inclusion of updated pediatric malnutrition indicators. An interprofessional team modified the existing STAMP for integration into the EHR. Audits were performed by the research dietitian to assess accuracy and provide feedback for continuous improvement of the tool design. A total of 3553 pediatric inpatients were studied from August 2017 to May 2019. Accuracy, sensitivity, and specificity improved with each modification to the EHR-STAMP. The final version of the EHR-STAMP found 85% accuracy, 89% sensitivity, and 97% specificity, with a positive predictive value of 60% and a negative predictive value of 94%. The EHR-STAMP is a highly reliable tool in the screening of nutrition risk for pediatric hospitalized patients. The tool is easy to use, EHR compatible, and incorporates the current indicators recommended for assessing pediatric malnutrition.

Assessment of Two Nutritional Screening Tools in Hospitalized Children.

Aim: to evaluate validity and concordance of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Screening Tool for Risk On Nutritional status and Growth (STRONGkids) screening tools for assessment of nutritional risk in pediatric inpatients. Methods: Prospective longitudinal observational multicenter study in children aged 1 month or older admitted as inpatients. Weight, height, cause of admission, demographic data, length of stay, and nutritional interventions were recorded. STAMP and STRONGkids were applied within the first 72 h of admission. Anthropometric measurements were recorded again 12–18 months after admission. Results: Eighty-one patients with median age of 4.1 years completed the study. Agreement between tools was moderate (κ = 0.47). STAMP had a greater tendency to classify patients as high risk (12.3% vs. 2.5%). Both tools showed very weak correlation with height for age. All undernourished patients at the beginning and the end of the study were classified as medium or high risk by STAMP and STRONGkids (100% sensitivity), although specificity was below 50% in all cases. There were no differences in length of stay based on nutritional risk with any of the tools. Conclusions: STAMP and STRONGkids demonstrated moderate agreement, with high sensitivity but low specificity for the diagnosis of undernutrition. Further studies are required to analyze cost-effectiveness of these tools and nutritional interventions derived from them.

Concordância entre ferramentas de triagem nutricional pediátrica em indivíduos com síndrome nefrótica

AIMS: To evaluate the concordance between three validated nutritional screening tools for pediatrics among themselves and the correlation with the anthropometric parameters of patients hospitalized with nephrotic syndrome.METHOD: Cross-sectional study with children and adolescents of both sexes hospitalized in the pediatric ward of a university hospital and diagnosed with nephrotic syndrome. Three nutritional screening instruments were applied: Screening of Risk for Nutritional Status and Growth (STRONGkids), Paediatric Yorkhill Malnutrition Score (PYMS) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). Data on weight, height and upper arm perimeter was collected, and three nutritional screening tools were applied: The estimate of relative agreement between the instruments was evaluated with the weighted Kappa test and the correlations with anthropometric parameters were assessed with the Spearman’s Correlation Test.RESULTS: We evaluated 11 patients, with a minimum age of 2 years and a maximum of 10 years. Screening tools detected prevalence of medium and high nutritional risk. Moderate agreement (k=0.47) was observed between PYMS and STAMP and there was no correlation between the screening tools’ result and the anthropometric data. Regarding the anthropometric parameters, 100% of the participants had adequate weight for age, 63.6% of the participants were diagnosed with normal weight by the BMI/Age index and 81.8% had adequate height for age according to the index Height/Age. After analysis of the upper arm perimeter, 27.3% were at risk of malnutrition.CONCLUSIONS: Despite the fact that are no recommendations for use of pediatric nutritional screening tools specific to each clinical situation, two of the three screening tools analyzed in this study demonstrated moderate agreement between them. However, the tested tools did not reflect the anthropometric nutritional status of the evaluated population.

Influence of nutritional status on clinical outcomes in hospitalised children

IntroductionPaediatric malnutrition during hospital admission is a prevalent comorbidity, which is estimated around 31.4% in our environment, and could influence the clinical outcomes of paediatric patients. ObjectiveThe aim of this study was to describe the malnutrition risk in hospitalised children using STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics), and to study its relationship with clinical outcomes. MethodsA single-centre, analytical and prospective study was conducted on children aged 1 month to 15 years hospitalised in a tertiary hospital between October and December 2017. An analysis was made of the clinical data and anthropometric measurements (weight, height, Waterlow weight classification). Patients were classified according to STAMP, which is a validated screening tool used to classify the risk of paediatric malnutrition during hospital admission. Multivariate statistical analysis was used to identify predictive variables of illness severity. ResultsAn analysis was made on a total of 200 patients (55% male), with a median age of 15.8 months (IQR 2.5–42.8), and a median length of stay of 3 days (IQR 1–18 days). Almost half (48.3%) of them had high risk of malnutrition at admission (STAMP ≥4), and 48.2% showed medium risk (STAMP 2–3). A higher STAMP score was associated with longer length of hospital stay (P<.01) and greater severity (P<.01). Multivariable analysis showed that STAMP could be a predictor of illness severity (OR 1.48, 95% CI: 1.18–1.86, P<.01). ConclusionsNearly 50% of hospitalised children have a high risk of malnutrition at admission according to the STAMP screening tool. Risk of malnutrition at admission measured according to STAMP nutritional screening was associated with a longer length of stay and greater severity of illness. It is important to evaluate the risk of malnutrition as this could be related to illness severity.

Malnutrition in Paediatrics: Stationary Screening & Follow-up.

The prevalence and follow-up of the clinical real-world data focussing on existing or risk of malnutrition in a tertiary hospital general paediatric ward including 4 months of follow-up was assessed. Measurements included anthropometric measurements, a nutrition interview and an extended version of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). R Studio 3.4.2 was used for statistical analysis and diagnosing malnutrition by calculating height-for-age (HfAz)-, weight-for-age (WfAz)- weight-for-height (WfHz)-, body mass index-for-age (BMIz) and mid-upper-arm circumference (MUACz)-z-scores with the childsds package with KIGGS and WHO for reference. The median age of the 68 participants was 8.00 (4.00-13.00) years. The main reasons for hospitalisation in the tertiary centre were gastrointestinal diseases, diabetes mellitus and rheumatic diseases. At admission 39.71%, at the second examination 36.00% and at the third examination 45.90% were malnourished. 68% of inpatients lost weight during their clinical stay, of which 35.29% lost more than 3% of their initial weight. However, changes were not significantly different. A significant share of patients was diagnosed to be malnourished at admission, the majority of patients lost weight during their hospital stay and the 4 months after admission. Due to the far reaching consequences for patients, doctors, health insurance and politics, the early diagnosis and treatment of malnutrition should take greater account in the future.

Comparison of four nutritional screening tools for Korean hospitalized children.

BACKGROUND/OBJECTIVESSeveral nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children.SUBJECTS/METHODSMedical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids).RESULTSA total of 559 patients (310 boys and 249 girls, mean age 6.3 ± 5.5 years) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting.CONCLUSIONDifferent nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

A survey on pediatric nutrition and nutritional support in 45 hospitals

Objective To investigate, through a survey on hospitals, the disciplinary development of pediatric nutrition and the present situation of clinical nutritional support in China, in an effort to inform and promote development of pediatric clinical nutrition. Methods A questionnaire was designed by the group of clinical nutrition, Chinese Pediatric Society, Chinese Medical Association. Respondents were 45 hospitals where members of the group work. The survey included 8 aspects in clinical work. Results Of all the 45 hospitals, 40 were grade-A tertiary hospitals; 4 were grade-B tertiary hospitals; and one was a secondary hospital. 25 (55.6%) of the surveyed hospitals were children's hospitals, and 20 (44.4%) were general hospitals. All the hospitals were divided into 8 groups according to their geographical distribution in China, and East China hosted the most while Northeast China had the least. Nutritional support team (NST) was set up in 32 (71.1%) hospitals, with head of the team majoring in the specialty/subspecialty of pediatric gastroenterology or clinical nutrition. In 39 (86.7%) hospitals, physicians working in the nutrition department were attending or above, and in 38 (84.4%) tertiary hospitals, chief of the nutrition department held an academic title of associate chief or above. 39 (86.7%) hospitals had nutrition clinics, 42 (93.3%) provided nutritional counseling, 40 (88.9%) involved nutritionists in consultations, 25 (55.6%) had independent nutritional rounds. Screening tools for nutritional risk and dysplasia in children(STRONGkids) and screening tool for the assessment of malnutrition in pediatrics (STAMP) were the most widely used tools for malnutrition screening, and the same with self-rating depression scale(SDS) and percentile for nutritional status evaluation. In the most surveyed hospitals, key institutional requirement and procedural protocol were put in place for the nutritional department. Conclusions Pediatric clinical nutrition was developing well in tertiary hospitals in China. NST was established in most institutions. There was strong toolkit for clinical nutritional support and sound administrative institutions. There is room, though, for further improvement. Key words: Pediatrics; Nutritional support; Survey