Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting

Abstract

BackgroundAn increased but unpredictable risk of malnutrition is associated with hospitalization, especially in children with chronic diseases. We investigated the applicability of Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids), an instrument proposed to estimate the risk of malnutrition in hospitalized children. We also evaluated the role of age and co-morbidities as risk for malnutrition.MethodsThe STRONGkids consists of 4 items providing a score that classifies a patient in low, moderate, high risk for malnutrition. A prospective observational multi-centre study was performed in 12 Italian hospitals. Children 1–18 years consecutively admitted and otherwise unselected were enrolled. Their STRONGkids score was obtained and compared with the actual nutritional status expressed as BMI and Height for Age SD-score.ResultsOf 144 children (75 males, mean age 6.5 ± 4.5 years), 52 (36%) had an underlying chronic disease. According to STRONGkids, 46 (32%) children were at low risk, 76 (53%) at moderate risk and 22 (15%) at high risk for malnutrition. The latter had significantly lower Height for Age values (mean SD value -1.07 ± 2.08; p = 0.008) and BMI values (mean SD-values -0.79 ± 2.09; p = 0.0021) in comparison to other groups. However, only 29 children were actually malnourished.ConclusionsThe STRONGkids is easy to administer. It is highly sensitive but not specific. It may be used as a very preliminary screening tool to be integrated with other clinical data in order to reliably predict the risk of malnutrition.

Detecting Undernutrition on Hospital Admission - Screening Tool Versus WHO Criteria

“…We also found a significant relationship between having a "high risk" score and younger age of the children. These results are in accordance not only with findings of the original publication of the STRONGkids in Dutch population but also with another recent study that tested the use of the STRONGkids in Italian hospitalized children [6,12]. This altogether confirms the validity of the STRONGkids questionnaire in different countries, as well as in Croatia.…”

Accuracy of Nutritional Screening Tools in Assessing the Risk of Undernutrition in Hospitalized Children

“…Hand searching of the reference lists and expert contacts yielded 1 extra article each (26,27). The flow diagram of the study selection process is shown in Figure 1.…”

Early or Late Parenteral Nutrition in Critically Ill Children: Practical Implications of the PEPaNIC Trial

“…Children with a score ≥2 were eligible for study participation. STRONGkids is a nutritional screening tool for hospitalized children based on a questionnaire that does not include any anthropometric measures [14,15,16,17]. The method has not been validated for critically ill children.…”