Study On The Nutrition Risk Screening And Influencing Factors For Malnutrition In Hospitalized Children With Hematological Tumor

Objective:Malnutrition is very common among children with hematological tumors, and it may be affected by various clinical treatments as well as the disease itself. Early detection of malnutrition and improvement in nutrition are important to improve the long term prognosis of children with hematological tumor. CVPYMS(Chinese Version Paediatric Yorkhill Malnutrition Score)which is composed of 4 indicators was employed to evaluate the nutrition risk of hospitalized children with hematological tumor to explore the practical application of CVPYMS in detecting nutrition risk and the nutritional status of hospitalized children with hematological tumor.Meanwhile the influencing factors were analyzed in order to provide some evidence for primary screen of nutrition risk and reasonable assessment of nutritional status.Methods: A convenience sampling method was used to select 350 hospitalized children who met the inclusion criteria in Department of Hemopathology in the hospital from January to October in 2015. The screening of nutrition risk was evaluated within 48 h by trained nurses and CVPYMS was employed. The purpose and significance were explained with verbal informed consent from the parent. And they were informed that there would be no extra cost but physical measurements and implementation which would not affect the physical and mental health of the children. Weight of the children was measured through a dedicated sitting RGZ-RT lever scale, and their height measured by a special measuring rod. Each child was required to repeat the measurement twice and the average was obtained. Numbers of weight were accurate in 0.1kg, and height in0.1cm. The data obtained was processed and analyzed by using SPSS 19.0, and such statistical approaches as statistical description, Mann-Whitney U test, Kruskal-Wallis H test, Logistic regression analysis were employed to analyze the condition and influencing factors of nutrition risks of the hospitalized children. The data would be regarded as statistically significant with P <0.05.Results:1 There were 69 cases with high nutrition risk among the 350 children, accounting for 19.72% of the total number, which included 2 with severe malnutrition, 18 with moderate nutrition risk and 49 with mild nutrition risk. There were 249 cases with moderate nutrition risk, accounting for 71.14% of the total number, which included 12 with mild malnutrition. And there were 32 cases with mild malnutrition, accounting for 9.14% of the total number.2 Univariate analysis of age showed that the 1-3-year and 12-16-year age groups suffered the highest nutrition risk which was followed by the 4-6-year age group and the 7-12-year age group suffered the lowest risk(P<0.01).3 Univariate analysis of chemotherapy length: children with repeated chemotherapies( ≧ 5times) suffered a highest constituent ratio of high nutrition risk which was followed by the ones with a few chemotherapies(<5 times). And there were significant differences in the nutritional status of children with different lengths of chemotherapy( P<0.01).4 Univariate analysis of tumor staging showed that the occurrence of clinical tumor staging in children was positively correlated with nutritional risk. The occurrence of clinical nutrition risk of children and staging of cancer was positively correlated, and the nutrition risk in children with advanced tumor was significantly higher than those with early or moderate tumor(P<0.05).5 Application of CVPYMS showed that three hundred and fifty cases selected in this study were all voluntary to be evaluated with a 100% acceptance rate.6 The univariate analysis and Logistic regression analysis showed that age, length of chemotherapy and stage of tumor were statistically significant for the nutrition risk status of hospitalized children(P<0.05), and the remaining factors were not statistically significant(P> 0.05).Conclusion:1Hospitalized children with hematological tumor suffered higher nutrition risk, and the children with high nutrition risk were vulnerable to malnutrition.2There was higher incidence of nutrition risk among 1-3-year and 12-16-year groups.3Children with longer length of chemotherapy suffered higher nutrition risks.4 The occurrence of clinical nutrition risk of children was positively correlated with staging of cancer. The nutrition risk in children with advanced tumor was significantly higher than those with early or moderate tumor.5 Age, length of chemotherapy, tumor stage were the three key factors affecting the nutrition risk of hospitalized children.6 CVPYMS is convenient to be operated in which shorter evaluation time was required, and can reflect the influence of different ages, chemotherapy lengths, stages of cancer on nutrition risks. So it is highly practical and is worth further promotion.