Hospital-acquired malnutrition in children with mild clinical conditions

Campanozzi, Angelo; Russo, Massimo; Catucci, Alessandra; Rutigliano, Irene; Canestrino, Gennaro; Giardino, Ida; Romondia, Arturo; Pettoello-Mantovani, Massimo

doi:10.1016/j.nut.2008.11.026

Cited by 94 publications

(94 citation statements)

References 19 publications

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“…Children of breastfeeding age require higher calorie intake per kilogram of body weight than older children and adolescents, so they are at greater risk of malnutrition during hospital stay. Campanozzi et al found a decrease of more than 0.25 SD in the BMI of 60 (24.4%) of the 246 children aged less than 24 months, and a decrease of 0.25 SD in the BMI of 37 (14.4%) of the 250 children aged more than 24 months included in their study (p < 0.001) [18].…”

Section: Hospital Malnutrition: Associated Factorsmentioning

confidence: 74%

“…An Italian study found that minors with malnutrition on admission had lost more BMI on discharge than those with better nutritional status on admission [18]. On the other hand, a Turkish study found that hospital stay had a negative impact on the nutritional status of children with mild malnutrition on admission but not of children with moderate malnutrition on admission [17].…”

Section: Hospital Malnutrition: Associated Factorsmentioning

confidence: 99%

“…A hospital stay longer than five days is considered a risk factor for malnutrition [15,18,21]. Length of hospital stay is multifactorial.…”

Section: Hospital Malnutrition: Associated Factorsmentioning

confidence: 99%

“…Some researchers use as the criterion hospital-acquired malnutrition the quantification of any weight loss [14], others define as a loss of weight greater than 2% [13] or a decrease in BMI greater than 0.25 SD [18]. Studies on the prevalence of hospital-acquired malnutrition or nutritional status deterioration during hospital stay are scarce6.…”

Section: Introductionmentioning

confidence: 99%

“…In France Sermet-Gaudelus et al reported that 191 (65%) of the 296 children admitted to the pediatric or pediatric surgery units lost weight during hospital stay; 85 children (44.5%) had lost 2-5% of their body weight, and 49 children (25.6%) had lost more than 5% of their body weight on discharge [13]. An Italian study found that the BMI of 97 children (19.5%) on discharge had decreased by more than 0.25 standard deviations [18].…”

Section: Introductionmentioning

confidence: 99%

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Hospital Malnutrition in Pediatric Patients: A Review

Mac¹

2017

Ann Nutr Disord Ther

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Malnutrition is common in pediatric inpatients, and nutritional status often deteriorates in the hospital. Although the prevalence of hospital malnutrition is high, this condition is ignored and consequently, not treated. The first step to fight malnutrition knows how to identify patients at greater risk of this condition. One way to identify them is by using risk screening tools, which should be used in all inpatients. Six screening tools have been created for pediatric patients, but none of these tools stood out. Nevertheless, the STRONGKids has been the most studied tool in many countries because of its ease and speed of use. In Brazil only STRONGKids has been translated and adapted, but just one study assessed its accuracy in our population, obtaining modest results. Hence, STRONGKids should be considered a preliminary tool, and its correlation with clinical data requires investigation.

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Section: Hospital Malnutrition: Associated Factorsmentioning

confidence: 74%

Section: Hospital Malnutrition: Associated Factorsmentioning

confidence: 99%

“…A hospital stay longer than five days is considered a risk factor for malnutrition [15,18,21]. Length of hospital stay is multifactorial.…”

Section: Hospital Malnutrition: Associated Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hospital Malnutrition in Pediatric Patients: A Review

Mac¹

2017

Ann Nutr Disord Ther

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Screening for Pediatric Malnutrition at Hospital Admission: Which Screening Tool Is Best?

et al. 2019

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Background Identifying children at malnutrition risk on admission to hospital is considered best practice; however, nutrition screening in pediatric populations is not common. The aim of this study was to determine which screening tool is able to identify children with malnutrition on admission to hospital. Methods A nurse administered 2 pediatric nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) and Pediatric Nutrition Screening Tool (PNST) to patients admitted to medicine and surgery units (n = 165). The Subjective Global Nutritional Assessment (SGNA) was then completed by a dietitian, blinded to the results of the screens. Sensitivity, specificity, and κ were calculated for both screening tools against the SGNA. A receiver operating characteristic (ROC) curve assessed alternate cutoffs for each tool. Length of hospital stay (LOS) was used to assess prospective validity. Results Using the recommended cutoffs, the sensitivity of STRONGkids was 89%, specificity 35%, and κ 0.483. The sensitivity of PNST was 58%, specificity 88%, and κ 0.601. Using adjusted cutoffs, PNST's sensitivity improved to 87%, specificity 71%, and κ 0.681, and STRONGkids specificity improved to 61%, sensitivity 80%, and κ 0.5. Children identified at nutrition risk had significantly longer LOS (P < 0.05). Conclusion This study showed neither tool was appropriate for clinical use based on published cutoffs. By adjusting the cutoffs using ROC curve analysis, both tools improved overall agreement with the SGNA without significantly impacting the prospective validity. PNST with adjusted cutoffs is the most appropriate for clinical use in this population.

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

et al. 2020

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Background: 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. Methods: 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. Results: 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%. Conclusion: 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.

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Hospital-acquired malnutrition in children with mild clinical conditions

Cited by 94 publications

References 19 publications

Hospital Malnutrition in Pediatric Patients: A Review

Hospital Malnutrition in Pediatric Patients: A Review

Screening for Pediatric Malnutrition at Hospital Admission: Which Screening Tool Is Best?

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

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