Clinical Application Of The STRONGkids And PNSS Nutritional Risk Screening In Children Hospitalized In The Department Of Gastroenterology

Objective: To explore the relationship between nutrition risk and clinical outcomes,and provide scientific basis for strengthening the nutrition management.Methods: A total of 1032 patients who hospitalized in the department of gastroenterology were investigated between Nov 2019 to Oct 2020,through sequential sampling.Inpatients were screened using Screening Tool for Risk on Nutritional status and Growth(STRONGkids)and pediatric nutritional screening score(PNSS)at admission.Data of laboratory indicators,nutritional support,complications and nosocomial infections,length of hospital stay,total hospitalization expenses were analyzed.Results: Among the 1032 patients,1-12 months:393 cases(38.1%);1-3 years:200 cases(19.4%);older than 3 years old:439 cases(42.5%).The incidence of nutritional risk was significantly higher in those children who younger than 3 years old(P<0.01).The results of nutritional risk screening with STRONGkids showed that 7.3% of patients with high nutritional risk,65.8% of patients with moderate nutritional risk,and 26.9% of patients with low nutritional risk.The results of nutritional risk screening with PNSS showed that 52.3% of patients with malnutrition risk and 47.7% of patients without malnutrition risk.WHO nutrition evaluation suggested that15.9% of patients with malnutrition.There was a positive correlation between the detection rate of nutrition risk and the detection rate of malnutrition,STRONGkids(r=0.237,p<0.01),PNSS(r=0.304,p<0.01).The agreement between PNSS and STRONGkids was moderate(k=0.521).Patients with Crohn’s disease,diarrhea and intestinal failure were more likely to be at risk of undernutrition.The red blood cells,hemoglobin,total serum protein,albumin,and prealbumin of patients with high nutritional risk were significantly lower than those patients with medium and low nutritional risk(p<0.01).Patients with high nutritional risk were associated significantly with longer length of hospital stay and more discharge costs.The incidence of complications and nosocomial infections were significantly higher than those of low and moderate nutritional risks.At the same time,the clinical remission rate of high nutritional risks is significantly lower than that of low and moderate nutritional risks(p<0.01).Among 1032 patients,only 34 children(3.3%)received nutritional support.Conclusion: In the Pediatric digestive ward,inpatients had a high incidence of nutritional risk.Compared with patients with no nutritional risk,patients with higher nutritional risk are more likely to have adverse clinical outcomes.Therefore,nutritional risk screening for inpatients should be strengthened.And patients who younger than 3 years old are high-risk groups for nutrition monitoring.Nutritional risk screening is helpful for better implementation of nutritional interventions.However,nutritional risk screening is not universal,and clinical nutritional support is unreasonable.It is necessary to strengthen nutritional support for children with nutritional risks.At present,there is no uniformly recommended pediatric nutrition risk screening tool.Both STRONGkids and PNSS can identify inpatients with nutritional risks.Which are worthy of clinical application.