Assessment of nutritional status in children with cancer: Significance of arm anthropometry and serum visceral proteins

Yaprak, Deniz Sül; Yalçın, Bilgehan; Pınar, Aslı; Büyükpamukçu, Münevver

doi:10.1002/pbc.28752

Cited by 18 publications

(32 citation statements)

References 42 publications

(77 reference statements)

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“…Routine use of arm anthropometry was rarely applied despite evidence that its use increases the recorded incidence of undernutrition when compared with indices based on weight and height. [1][2][3] Measures derived from height and weight, including BMI, were also inconsistently utilised, although interpretation of such data may be difficult as they fail to identify changes in body composition [4][5][6] for which a number of methodologies exist, although dual-energy X-ray absorptiometry (DEXA) is the clinical gold standard. 42 The limited use of dynamometry and bioelectrical impendence may reflect limited normative values for these meth-ods of assessment in children as well as difficulties with access to equipment.…”

Section: Discussionmentioning

confidence: 99%

“…The limited use of centile charts further constrains the utility of the height and weight data. Routine use of arm anthropometry was rarely applied despite evidence that its use increases the recorded incidence of undernutrition when compared with indices based on weight and height 1–3 . Measures derived from height and weight, including BMI, were also inconsistently utilised, although interpretation of such data may be difficult as they fail to identify changes in body composition 4–6 for which a number of methodologies exist, although dual‐energy X‐ray absorptiometry (DEXA) is the clinical gold standard 42 .…”

Section: Discussionmentioning

confidence: 99%

“…No single measure defines nutritional state and measurement of body size, and composition remains the most frequent approach. [1][2][3][4][5][6] Nutrition screening tools are brief risk assessments carried out by health care professionals to identify those who are either likely to be malnourished or at risk of becoming malnourished, warranting more detailed nutritional assessment and intervention. 7 Some tools are designed for nutritional screening in hospitalised children in general and include STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics), PYMS (Paediatric Yorkhill Malnutrition Score), STRONG Kids, and PNRS (Pediatric Nutrition Risk Score), [8][9][10][11] but the optimal choice is debated.…”

Section: Introductionmentioning

confidence: 99%

“…Other markers include the quantity and quality of the diet, together with physiological and metabolic markers of function such as physical function and micronutrient status. No single measure defines nutritional state and measurement of body size, and composition remains the most frequent approach 1–6 …”

Section: Introductionmentioning

confidence: 99%

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Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom

Henry,

Aldiss,

Gibson

et al. 2022

Pediatric Blood & Cancer

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Background: Both under-and overnutrition may have adverse impact on outcome of cancer in children and teenagers/young adults (CTYA). Previous studies confirm that screening for nutritional risk and detection of nutritional abnormality is inconsistently undertaken in practice. Methods:We undertook a survey of dietetic resource and nutritional assessment in CTYA principal treatment centres (PTC) in the United Kingdom. Responses were received from 95% children's and 69% TYA PTC.Results: Only 13/18 (72%) children's PTC, and one of 11 (9%) TYA PTC, met national standards for dietetic resource; one of 18 (6%) paediatric and six of 11(54%) TYA PTC had no such resource. While resources were greater in larger paediatric PTC, who were also most likely to undertake stem cell transplantation, resources in TYA PTC were too low to assess relationship to centre size. Most centres focused resources on inpatient care and <50% considered staffing adequate; 82% used nutritional screening tools but without consistency in the tool used. Weight and height were the principal method for assessment, but with inconsistency in the frequency of measurement and use in different clinical settings. Measures derived from weight and height, including body mass index (BMI), were inconsistently utilised. The use of arm anthropometry was rare despite evidence that use increases recognition of undernutrition. Detailed nutritional assessment was infrequently attempted. Conclusion:Barriers to adequate nutritional assessment and treatment for all patients include resource limitations (particularly TYA), training for staff, and uncertainty about detailed assessment of nutritional status. There is a need to harmonise screening and assessment of nutritional status in CTYA with cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom

Henry,

Aldiss,

Gibson

et al. 2022

Pediatric Blood & Cancer

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“…Malnutrition is an imbalance situation between nutritional needs and intake, leading to insufficient accumulation of energy, protein or micronutrients that may have a negative impact on growth, development, and other related results (7). It is one of the common symptoms appeared in patients with PRS.…”

Section: Discussionmentioning

confidence: 99%

Study on the Effect of Bilateral Mandible Distraction Osteogenesis About the Nutrition Status of Infants With Pierre-Robin Sequence

et al. 2021

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Objective: By comparing and studying the changes of food intake, weight, body length, BMI, blood albumin level and other indicators of infants with Pierre-Robin Sequence (PRS) before and after Bilateral Mandible Distraction Osteogenesis operation, to explore the effect of distraction osteogenesis on PRS patients about the improvement of nutrition status.Methods: The children with PRS who admitted to the Oral and Maxillofacial Surgery Department of Guangzhou Women and Children's Medical Center from July 2015 to December 2020 were selected. All patients accepted bilateral mandible distraction osteogenesis surgery, and the pre- and post-operative indicators were recorded, such as food intake, weight, length, blood albumin level and others. BMI was calculated based on the indicators mentioned above, and comparative statistical analysis was performed.Results: 1. All patients were fed with whole milk before the first surgery, and the average calorie per kg was 91.8 kcal/kg, significantly lower than the standard (100–150 kcal/kg), suggesting the overall nutritional intake of PRS patients is low; 2. t tests for independent samples were used to analyze the pre-operative and post-operative indicators. The WFA percentile increased from 14.16 ± 2.17 to 15.01 ± 1.85% (P = 0.0048), WFA z score increased from −2.40 ± 0.18 to −1.90 ± 0.14 after the surgery (P = 0.0010), LFA percentile increased from 20.04 ± 3.48 to 33.67 ± 4.29% (P = 0.0098), LFA z score increased from −2.09 ± 0.19 to −1.42 ± 0.23 (P = 0.0009), BMI z score increased from −1.95 ± 0.22 to −1.39 ± 0.16 (P = 0.0408), ALB raised from 37.06 ± 0.51 to 42.85 ± 0.30 g/L (P < 0.001), which indicating that the physique of patients improved after the distraction osteogenesis surgery, mainly was reflected by the lifting of weight and length growth curves; the body shape also improved, indicating that the patients' nutrition status after the surgery is also improved.Conclusion: Bilateral mandible distraction osteogenesis surgery has a positive effect on the nutrition status of children with PRS. This effect is mainly reflected by the improvements of the body physical indicators after surgery.

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Nutritional status associated with clinical outcomes in children with solid tumors: A retrospective cohort study from China

Li,

Lu,

et al. 2023

Cancer Medicine

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ObjectiveTo investigate the long‐term changes in nutritional status in children with solid tumors during treatment and the relationship between nutritional status and clinical outcomes.MethodsThis study was a retrospective medical records review of data from children who were diagnosed with solid tumors and followed up for more than 3 months from January 2016 to December 2021 in China. Patient demographics and clinical information, including nutritional status, parenteral nutrition use, intensive care unit (ICU) transfers, infection during hospitalization, hospitalization frequency, length of stay, hospitalization costs and antibiotic costs, were collected to analyze the nutritional status of children with different types of solid tumors, the dynamic changes in nutritional status during treatment, and the relationship between nutritional status and clinical outcomes.ResultsAmong the 764 patients (383 males (50.1%); 381 females (49.9%); mean age: 2.58 years), 41.6% of the solid tumors were neuroblastomas, 17.1% were hepatoblastomas, and Wilms tumors as the third most common solid tumors (8.9%). The median follow‐up duration was 6 months (range: 3–40 months). At diagnosis, the proportion of children who were undernourished (underweight and wasting) versus overweight or obese were 26.71% versus 5.21% (25.86% vs. 2.89% in the third month; 29.77% vs. 2.28% in the sixth month; 24.77% vs. 3.27% in the 12th month). The body mass index Z scores decreased from the initial values after the first month (−0.56 (−1.47, 0.23) vs. −0.44 (−1.29, 0.41)) but improved later and decreased again at 6 months. The children in the undernutrition group had longer hospital stays (p < 0.001), higher hospitalization costs (p < 0.001), higher antibiotic costs (p < 0.001), a higher risk of neutropenia (OR = 4.781 (95% CI: 1.571–14.553), p = 0.006), and a higher risk of ICU transfers (OR = 1.498 (95% CI: 1.010–2.224), p = 0.044). No significant differences in those associations by malnutrition and infection, ICU duration, or length of parenteral nutrition were observed.ConclusionThere is a considerable prevalence of malnutrition in children with solid tumors. Malnutrition is related to adverse clinical outcomes and increases in total hospital expenses and antibiotic costs.

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Assessment of nutritional status in children with cancer: Significance of arm anthropometry and serum visceral proteins

Abstract: Deniz Sül Yaprak and Bilgehan Yalçın contributed equally to this work.

Cited by 18 publications

References 42 publications

Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom

Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom

Study on the Effect of Bilateral Mandible Distraction Osteogenesis About the Nutrition Status of Infants With Pierre-Robin Sequence

Nutritional status associated with clinical outcomes in children with solid tumors: A retrospective cohort study from China

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