Performance of the new nutritional evaluation tool for hospitalized pediatric cancer patients (ANPEDCancer)

Abstract

Background: There is a lack of specific nutritional assessment tools for the pediatric population with hospitalized cancer. The aim was to evaluate the performance of ANPEDCancer in a pediatric population with cancer, verifying its ability to detect nutritional inadequacy and predict the length of hospital stay. Methods: We evaluated 111 pediatric patients hospitalized in a cancer reference institute in 2019. Patients were classified as malnourished and well-nourished, according to the ANPEDCancer, and measures of weight, height, anthropometric indicators, body composition, laboratory parameters, length of hospital stay, and death were compared between groups. The ANPEDCancer classification was compared with the complete nutritional assessment, calculating sensitivity, specificity, and predictive values, and with prolonged hospital stay. Results: The prevalence of malnutrition was 12.6%, nutritional risk was 48.6%, risk of overweight/obesity was 6.3%, and well-nourished status was 32.4%. According to ANPEDCancer, malnourished patients showed a higher frequency of inadequacy for all anthropometric indices, percentage of weight loss, albumin, C-reactive protein (CRP), and longer hospital stay when compared to well-nourished patients. There was an association between the tool’s diagnosis and measures of body composition, CRP, and length of hospital stay. ANPEDCancer validation with the complete nutritional assessment showed a sensitivity of 81.6%, specificity of 55%, positive predictive value of 53.4%, and negative predictive value of 82.5%. The length of hospital stay was almost twice as long among malnourished patients. Conclusions: ANPEDCancer is feasible to assess nutritional status and identify the presence of nutritional risk, allowing targeted assistance in the hospitalized pediatric cancer patients pediatric.