More training and awareness are needed to improve the recognition of undernutrition in hospitalised children

Huysentruyt, Koen; Goyens, Philippe; Alliet, Philippe; Bontems, Patrick; Hautem, Hilde H. Van; Philippet, Pierre; Vandenplas, Yvan; Schepper, Jean De

doi:10.1111/apa.13014

Cited by 15 publications

(15 citation statements)

References 10 publications

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“…Low staff awareness on nutrition, lack of time and lack of local guidelines for nutrition screening were the most important barriers to the routine evaluation of DAM. These results are very similar to the findings of a Belgian survey in secondary care hospitals 14 . The differences across countries in the perceived barriers of routine evaluation of DAM may reflect variation in health practices, resources and agreed health priorities across countries.…”

Section: Discussionsupporting

confidence: 90%

Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: Results from an international survey

et al. 2019

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HP who routinely assess and treat children with DAM identified ongoing weight loss, increased losses, increased requirements, low intake and high nutritional risk conditions as the most important clinical indicators of DAM. These clinical indicators should now serve as a basis to form clinical-based criteria for the identification of DAM in routine clinical practice. Low awareness, lack of guidelines or local policy and lack of resources were the most important barriers of routine screening.

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Section: Discussionsupporting

confidence: 90%

Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: Results from an international survey

et al. 2019

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“…Median (interquartile range, IQR) LOS was also longer in acutely malnourished children than in those not acutely malnourished (17.5 days, 12–58 vs. 5 days, 2–13, respectively), ( p = 0.051). The LOS for those whose height SD was below and above − 2 SD was 14 days (4–121) and 4.5 days [2–12], respectively ( p = 0.090). Age of the child did not differ between malnourished or well-nourished groups or between the risk scores of any of the screening methods.…”

Section: Resultsmentioning

confidence: 99%

“…Malnutrition is an underrecognized problem leading to an increased risk for complications, longer hospital stays, and decreased quality of life [1, 2]. Several guidelines suggest that pediatric hospital inpatients should be screened for malnutrition risk [3].…”

Section: Introductionmentioning

confidence: 99%

Nutritional risk screening—a cross-sectional study in a tertiary pediatric hospital

Tuokkola

Hilpi

Kolho

et al. 2019

J Health Popul Nutr

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BackgroundAll hospitalized patients should be screened for malnutrition risk. No universal method exists for pediatric patients.MethodsWe performed a cross-sectional study comparing three published malnutrition risk screening tools (PYMS, STAMP, and STRONGkids), applying them to each inpatient aged 1 month to 17 years over a period of five consecutive weekdays in Helsinki University Hospital, Finland.ResultsOf the eligible patients, 67% (n = 69) participated. We found that 6.2% of the children were acutely malnourished and accurately categorized by the three tools. STRONGkids showed the highest specificity (100%) and positive predictive value (36%). Acute malnutrition seemed to be associated with longer hospital stay (p = 0.051).ConclusionSTRONGkids was the most accurate screening tool for detecting acute malnutrition and was therefore chosen as the screening method in our hospital. Routine screening for the risk of malnutrition in pediatric inpatients is important in detecting at-risk children who would otherwise be left without dietary intervention.Electronic supplementary materialThe online version of this article (10.1186/s41043-019-0166-4) contains supplementary material, which is available to authorized users.

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“…Serum albumin and pre-albumin are routinely used in clinical practice as biochemical indicators of nutritional status. In a national survey published in 2015, we reported that more than one-third of Belgian paediatric departments considered serum protein levels in their nutritional assessment (1). However, both serum markers were said to be unreliable nutritional indicators in calorically restricted individuals without physical illness in a systematic review, which contained mainly adult data and a combination of different small studies in adolescents (2).…”

Section: Introductionmentioning

confidence: 99%

Albumin and pre‐albumin levels do not reflect the nutritional status of female adolescents with restrictive eating disorders

et al. 2016

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Aim: Albumin and pre-albumin are frequently used as nutritional markers in clinical practice. We examined whether serum albumin and pre-albumin were predicted by body mass index (BMI), hydration and/or inflammation in female adolescents with a recently diagnosed restrictive eating disorder (RED).Methods: This was a retrospective study of female adolescents with RED from 2002 to 2011. Low albumin and pre-albumin levels were defined as <3.5 g/dL and <20 mg/dL, respectively. We assessed inflammation using the erythrocyte sedimentation rate (ESR) and dehydration using the haematocrit levels.Results: We included 75 females with a mean age of 15.2 years and 64% had a BMI Z score of <À2. The mean albumin and pre-albumin levels were 4.8 g/dL and 22.2 mg/dL, respectively, with 24% of the children having low pre-albumin and none having low albumin levels. The stepwise multiple regression for albumin identified ESR and haematocrit as significant predictors, which explained 14.8% of the variance. Age was the only significant predictor for pre-albumin, which explained 15.3% of the variance.Conclusion: Albumin, but not pre-albumin, levels were primarily predicted by low-grade inflammation and hydration, but not by BMI. These markers should not be used to assess nutritional status in adolescents with RED.

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More training and awareness are needed to improve the recognition of undernutrition in hospitalised children

Abstract: Half of the paediatric departments in Belgian secondary-level hospitals did not carry out nutritional screening, and differences in current practices and attitudes may be due to cultural and/or educational differences.

Cited by 15 publications

References 10 publications

Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: Results from an international survey

Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: Results from an international survey

Nutritional risk screening—a cross-sectional study in a tertiary pediatric hospital

Albumin and pre‐albumin levels do not reflect the nutritional status of female adolescents with restrictive eating disorders

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