Development and validation of a pediatric nutritional screening score (PNSS) for hospitalized children.

Abstract

BACKGROUND AND OBJECTIVES:

There is no evidence on the most effective nutritional screening tool for hospitalized children. The objective of this study was to develop and validate a pediatric nutritional screening tool to assess undernutrition risk upon hospital admission.

METHODS AND STUDY DESIGN:

The study had a two-phase prospective observational design. A novel pediatric nutritional screening score (PNSS) was developed and sensitivity, specificity, and reliability were evaluated by comparing with a complete dietetic assessment. Length of hospital stay, weight loss, disease complications, and nutritional support were recorded.

RESULTS:

PNSS consisted of three elements: disease with malnutrition risks, changes in food intake, and anthropometric measurements, with a score of 0-2 for each element. The optimal cut-off score to identify patients (n=96) at risk of undernutrition was two. The agreement between PNSS and the complete dietetic assessment was moderate (κ=0.435, 95% CI=0.373-0.498). Sensitivity and specificity values of PNSS were 82% (95% CI=76%-87%) and 71% (95% CI=67%-74%), respectively. Inter-rater agreement had a κ value of 0.596 (95% CI=0.529-0.664, p<0.001). The percentage of children with undernutrition risk was 44.9%. Children with oncologic, gastrointestinal, and cardiac diseases were most likely to be at risk of undernutrition. The at-risk group was associated significantly with longer length of hospital stay and higher percentage of weight loss compared with the not-at-risk group.

CONCLUSION:

PNSS is the first nutritional screening tool developed for hospitalized children and validated in a large population of patients in China.

• Authors: Lina Lu, Xiaomeng Mao, Jinye Sheng, Jianhu Huang, Ying Wang, Qingya Tang, Wei Cai
• Journal: Asia Pacific journal of clinical nutrition (Asia Pac J Clin Nutr) 2018 Vol. 27 Issue 1 Pg. 65-71 ISSN: 0964-7058 [Print] China
• PMID: 29222881 (Publication Type: Journal Article, Observational Study, Validation Study)

Topics

• Adolescent
• Anthropometry
• Child
• Child, Hospitalized (statistics & numerical data)
• Child, Preschool
• China
• Eating
• Hospitalization (statistics & numerical data)
• Humans
• Infant
• Length of Stay (statistics & numerical data)
• Malnutrition (diagnosis)
• Nutrition Assessment
• Reproducibility of Results
• Risk Factors
• Sensitivity and Specificity