| Background and AimsDespite advances in many areas of pediatric medicine, studies from Europe and the United States still demonstrate a malnutrition prevalence of 6-32% among hospitalized pediatric patients.Critically ill childreInn in pediatric intensive care units (PICUs) are at particularly high risk of developing mamutrition.Malnutrition in children not only have a significant impact on growth, but also increasing infections,the whole hospital expenses and prolonging hospital stays. A large part of these patients are undernourished when admitted, and in the majority of these, undernutrition develops further while in hospital. This can be avoided if special attention be paid to their nutritional status.Therefore, the need of a widely accepted screening system which will detect patients who might benefit clinically from nutritional support is commonly seen as a major factor to improvement.During recent decades,several nutritional risk screening tools for children have been established and developed. The primary aims of this study, on one hand is to compare the validity of STRONGkids and STAMP in nutritional risk screening for hospitalized children, and analyse if there is some correlation between nutritional risk scores and clinical outcomes.On the other hand is to know the trend of nutritional status of the pediatric inpatients by repeated evaluation.MethodsIn a cross-sectional study some trained investigators applied Improved STRONGkids (Improved Screening Tool for Risk of Impaired Nutritional Status and Growth) and STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) at the same time, to assess the nutritional risk of 1176 paediatric inpatients from 6 different departments (Respiratory dept, Gastroenterology dept, Cardiovascular dept, General surgery dept, Oncological surgery dept, Cardio-Thoracic surgery dept) from February 5th to May 30th,2014.Admission number (AD), name, sex, age, weight, height, diagnosis were recorded when they admitted.Hemoglobin, serum albumin, modified diagnosis, operations, weight loss, complications and nutritional support were recorded during there hospitalization.The final diagnosi, length of stay,hospital expenses were recorded when dischared.Trained doctors applied STRONGkids and STAMP tools to assessed nutritional risk by using the same questionnaire when children admitted, then reevaluated their nutritional risk when discharged.All the data was analyzed using the SPSS 18.0 program. The statistic methods included T test, Chi-square test, ANOVA and correlation analysis.ResultsOf the 1176 cases,1136 had complete clinical informations.The 1136 children assessed by STRONGkids and STAMP were assessed as:STRONGkids:9.5% high risk,76.8% medium risk and 13.7% low risk.STAMP:23.8% high risk,63.7% medium risk and 12.5% low risk.The distribution of the nutritional risk differs from departments and ages.The incidence of high nutritional risk was significantly higher in infants than in other ages groups,and was significantly higher in gastroenterology dept and surgical dept than in other departments(P<0.01).Children with high nutritional risk had significantly increased hospital stays,expenses and higher nutritional supports than those with moderate or low nutritional risk.Reevaluation in discharge, both STRONGkids and STAMP show that the incidence of high and moderate nutritional risk decreased.(P<0.01).It aslo differs from different departments and age groups.ConclusionThe incidence of nutritional risk is high in pediatric inpatients,especially in gastroenterology dept and surgical dept,and infants.Nutritional risk scores is correlated with clinical outcomes.Reevaluation in discharge differs from the evaluation in admission,in order to discover the children with malnutrition earlier, dynamic monitoring should be given to inpatients.STRONGkids and STAMP can be used to screen malnutritional chilren,but for widely applied, it should be improved by concerning the nutritional status and the categories of disease of Chinese children. |
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