Detecting Undernutrition on Hospital Admission - Screening Tool Versus WHO Criteria
Clinical Medicine Research
Volume 6, Issue 3, May 2017, Pages: 74-79
Received: Jan. 27, 2017;
Accepted: Mar. 14, 2017;
Published: Apr. 10, 2017
Views 2302 Downloads 111
Zrinka Matak, Zagreb School of Medicine, Zagreb, Croatia
Duska Tjesic-Drinkovic, Zagreb School of Medicine, Zagreb, Croatia; Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
Lana Omerza, Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
Irena Senecic-Cala, Zagreb School of Medicine, Zagreb, Croatia; Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
Jurica Vukovic, Zagreb School of Medicine, Zagreb, Croatia; Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
Dorian Tjesic-Drinkovic, Zagreb School of Medicine, Zagreb, Croatia; Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
Follow on us
To prevent the development of malnutrition in hospitalized children, it is important to develope an early identification of nutritional depletion, ideally at the time of admission to the hospital. In 2009 Hulst et al. proposed new guidelines for assessing the nutritional status of hospitalized children called STRONGkids questionnaire (Screening Tool Risk on Nutritional Status and Growth). This study was designed to describe the current prevalence of malnutrition on admission to a pediatric gastroenterology hospital unit and to compare the value and feasibility of STRONGkids scoring system versus anthropometric World Health Organization (WHO) criteria in identifying children at risk of developing malnutrition during hospital stay. The prospective observational study involved 124 children hospitalized at the Department of Pediatrics, University Hospital Center Zagreb. Nutritional status and risk for malnutrition were estimated by STRONGkids questionnaire and anthropometric measurements of subjects. Statistical analysis was performed using the computer program STATISTICS 10, StatSoft. Inc. 1984-2011; using descriptive statistics, Fisher's exact (FE) test and non-parametric Kruskal-Wallis (KW) test. Total malnutrition was observed in 18.5% of patients. Larger number of children at risk for malnutrition were identified by STRONGkids questionnaire than by anthropometric measurements (STRONGkids questionnaire: 75.8%; anthropometric measures: 40.3%). Patients that lost weight during hospitalization (33.1%) were further analyzed: 8/41 were not detected to be at risk by either method, 11/41 were identified by STRONGkids and anthropometry, and 22/41 were detected only by STRONGkids (Fisher's exact test p=0,08). This study justifies the inclusion of the STRONGkids questionnaire in the initial evaluation of children on admission to the hospital, in order to recognize those who need special nutritional support and thus prevent the development of malnutrition during hospitalization.
Nutritional Status, Hospitalized Children, Malnutrition, STRONGkids, Screening Tool, Anthropometry
To cite this article
Detecting Undernutrition on Hospital Admission - Screening Tool Versus WHO Criteria, Clinical Medicine Research.
Vol. 6, No. 3,
2017, pp. 74-79.
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics. Clin Nutr. 2006; 25:180–186.
Mosby TT. Almost a fifth of children admitted to Dutch hospitals have acute or chronic malnutrition; risk factors include underlying disease and non-white ethnicity. Evid Based Nurs. 2010; 13:81-82.
Kapçı N, Akçam M, Koca T, Dereci S, Kapcı M. The nutritional status of hospitalized children: Has this subject been overlooked? Turk J Gastroenterol. 2015; 26:351-355.
Hartman C, Shamir R, Hecht C, Koletzko B. Malnutrition screening tools for hospitalized Children. Curr Opin Clin Nutr Metab Care. 2012; 15(3):303-309.
Aurangzeb B, Whitten KE, Harrison B, et al. Prevalence of malnutrition and risk of under-nutrition in hospitalized children. Clin Nutr. 2012; 31(1):35-40.
Hulst JM, Zwart H, Hop WC, Joosten KFM. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children. Clin Nutr. 2010; 29:106–111.
WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Pediatr. 2006; 450:1-101.
World Health Organization. Child growth standards: WHO Anthro (version 3.2.2, January 2011) and macros countries [Internet]. World Health Organization. 2011. Available at: www.who.int/childgrowth/software/en/. Accessed 02 Mai 2013.
Koen FM, Joosten MD, Jessie M, Hulst MD. Malnutrition in pediatric hospital patients: Current issues. Nutrition. 2011; 27:133-137.
Hwang EH, Park JH, Chun P, Lee YJ. Prevalence and Risk Factors for the Weight Loss during Hospitalization in Children: A Single Korean Children’s Hospital Experience. Pediatr Gastroenterol Hepatol Nutr. 2016; 19(4):269–275.
Joosten KFM, Hulst JM. Prevalence of malnutrition in pediatric hospital patients. Curr Opin Pediatr. 2008; 20:590–596.
Spagnuolo MI, Liguoro I, Chiatto F, Mambretti D, Guarino A. Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting. Ital J Pediatr.2013;39:81.
Hecht C,Weber M, Grote V, et al. Disease associated malnutrition correlates with length of hospital stay in children. Clin Nutr. 2015; 34:53-59.
Huysentruyt K, Alliet P, Muyshont L, et al. The STRONGkids nutritional screening tool in hospitalized children: A validation study. Nutrition. 2013; 29:1356–1361.
Moeeni V, Walls T, Day AS. Assessment of nutritional status and nutritional risk in hospitalized Iranian children. Acta Paediatr. 2012; 101:446–451.