scholarly journals Development of a simple and valid nutrition screening tool for pediatric hospitalized patients with acute illness

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 173
Author(s):  
Hoda Atef ◽  
Rasha Abdel-Raouf ◽  
Ahmed S. Zeid ◽  
Eman H. Elsebaie ◽  
Shaimaa Abdalaleem ◽  
...  

Background: Nutritional screening, intervention and assessment in patients with undernutrition are key components of any nutritional care. The goal of any nutritional assessment is to determine the specific nutritional risk(s). Presently, there are no guidelines on any ideal screening tool to be used on admission for identification of children that are at risk of developing malnutrition during their hospital stay. The objective of the study was to develop a valid and simple nutritional screening tool which can be used on hospital admission to identify pediatric patients at risk of malnutrition. Methods: This study was cross sectional analytical that enrolled children (n:161) admitted with acute illness to the general wards at Cairo University Children Hospitals (CUCH). The answers to the developed questionnaire were compared to the Subjective Global Assessment (SGA), those with high accuracy (≥80%) were used for validity with anthropometric measures. Results: In the ‘less than two years of age’ group, the simple and valid nutritional screening tools were the following questions: (Is there a problem during breast-feeding?), (Is there scanty breast milk?), (Is there appetite loss?). The simple and valid nutritional screening tools during the ‘early childhood’ group were the following questions: (Is there appetite loss?), (Is there any skipping of meals?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). The simple and valid  nutritional screening tools during the ‘late childhood’ group were the following questions: (Is there appetite loss?), (Are they watching TV, videotapes and/or playing computer games for more than two hours/day?). Conclusion: The simple and valid nutritional screening tools differ according to age groups. The one which is valid in all ages is the question about the appetite loss.

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3899
Author(s):  
Camilla Fiorindi ◽  
Gabriele Dragoni ◽  
Stefano Scaringi ◽  
Fabio Staderini ◽  
Anita Nannoni ◽  
...  

Background: Accurate identification of malnutrition and preoperative nutritional care in Inflammatory Bowel Disease (IBD) surgery is mandatory. There is no validated nutritional screening tool for IBD patients. We developed a novel nutritional screening tool for IBD patients requiring surgery and compared it with other tools. Methods: we included 62 consecutive patients scheduled for elective surgery. The IBD Nutritional Screening tool (NS-IBD) was developed to screen patients for further comprehensive assessment. NRS-2002, MUST, MST, MIRT, SaskIBD-NR are compared with the new test. All screening tests were subsequently related to new GLIM criteria. Results: according to GLIM criteria, 25 (40%) IBD patients were malnourished (15 CD and 10 UC, 33% vs. 63%, p = 0.036). Stage 1 malnutrition was reported in ten patients, while stage 2 was detected in 15 patients. The comparison of each nutritional risk tool with GLIM criteria showed sensitivity of 0.52, 0.6, 0.6, 0.84, 0.84 and 0.92 for SASKIBD-NR, MUST, MST, NRS-2002, MIRT, and the new NS-IBD, respectively. Conclusions: in IBD, currently adopted nutritional screening tools are characterized by a low sensitivity when malnutrition diagnosis is performed with recent GLIM criteria. Our proposed tool to detect malnutrition performed the best in detecting patients that may require nutritional assessment and preoperative intervention.


2019 ◽  
Vol 122 (12) ◽  
pp. 1368-1376 ◽  
Author(s):  
Alexandra Georgiou ◽  
Georgios V. Papatheodoridis ◽  
Alexandra Alexopoulou ◽  
Melanie Deutsch ◽  
Ioannis Vlachogiannakos ◽  
...  

AbstractMalnutrition risk screening in cirrhotic patients is crucial, as poor nutritional status negatively affects disease prognosis and survival. Given that a variety of malnutrition screening tools is usually used in routine clinical practice, the effectiveness of eight screening tools in detecting malnutrition risk in cirrhotic patients was sought. A total of 170 patients (57·1 % male, 59·4 (sd 10·5) years, 50·6 % decompensated ones) with cirrhosis of various aetiologies were enrolled. Nutritional screening was performed using the Malnutrition Universal Screening Tool, Nutritional Risk Index, Malnutrition Screening Tool, Nutritional Risk Screening (NRS-2002), Birmingham Nutritional Risk Score, Short Nutritional Assessment Questionnaire, Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) and Liver Disease Undernutrition Screening Tool (LDUST). Malnutrition diagnosis was defined using the Subjective Global Assessment (SGA). Data on 1-year survival were available for 145 patients. The prevalence of malnutrition risk varied according to the screening tools used, with a range of 13·5–54·1 %. RFH-NPT and LDUST were the most accurate in detecting malnutrition (AUC = 0·885 and 0·892, respectively) with a high sensitivity (97·4 and 94·9 %, respectively) and fair specificity (73·3 and 58 %, respectively). Malnutrition according to SGA was an independent prognostic factor of within 1-year mortality (relative risk was 2·17 (95 % CI 1·0, 4·7), P = 0·049) after adjustment for sex, age, disease aetiology and Model for End-stage Liver Disease score, whereas nutrition risk according to RFH-NPT, LDUST and NRS-2002 showed no association. RFH-NPT and LDUST were the only screening tools that proved to be accurate in detecting malnutrition in cirrhotic patients.


1999 ◽  
Vol 58 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Jacqueline Edington

The present paper explores the problems associated with assessment of nutritional status in the community and reviews the literature related to this subject. The first problem is one of terminology, since a logical first step before assessment is screening, which identifies characteristics known to be associated with dietary or nutritional problems. Its purpose is to differentiate individuals who are at high nutritional risk or have poor nutritional status. There are certain factors which should alert the primary health care team to the fact that nutritional intake may be reduced and that risk of malnutrition is increased. These include disease condition, functional disabilities, inadequate or inappropriate food intake, poor dentition or difficulty swallowing, polypharmacy, alcoholism, depression, poor social circumstances or recent discharge from hospital. Patients suffering from these factors need to be identified so that screening becomes a routine part of their medical treatment. At-risk groups include the elderly, the chronically ill, those with cancer and neurological disorders, post-surgical patients and children with developmental disabilities. In the community, practice and community nurses see the majority of at-risk patients and should carry out screening. A number of screening tools have been developed for community use. Most are aimed at the elderly population, but there are others designed to assess nutritional risk in children with developmental disabilities and the general population. These are reviewed and problems of content and validity identified. Some problems associated with nutritional assessment are also reviewed.


Parasite ◽  
2020 ◽  
Vol 27 ◽  
pp. 74
Author(s):  
Zhan Wang ◽  
Jin Xu ◽  
Ge Song ◽  
MingQuan Pang ◽  
Bin Guo ◽  
...  

Background: Echinococcosis is a chronic consumptive liver disease. Little research has been carried out on the nutritional status of infected patients, though liver diseases are often associated with malnutrition. Our study investigated four different nutrition screening tools, to assess nutritional risks of hospitalized patients with echinococcosis. Methods: Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the Nutrition Risk Index (NRI) were used to assess 164 patients with alveolar echinococcosis (AE) and 232 with cystic echinococcosis (CE). Results were then compared with European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition diagnosis. Results: According to ESPEN standards for malnutrition diagnosis, 29.2% of CE patients and 31.1% of AE patients were malnourished. The malnutrition risk rates for CE and AE patients were as follows: NRS 2002 – 40.3% and 30.7%; MUST – 51.5% and 50.9%; MNA-SF – 46.8% and 44.1%; and NRI – 51.1% and 67.4%. In patients with CE, MNA-SF and NRS 2002 results correlated well with ESPEN results (k = 0.515, 0.496). Area-under-the-curve (AUC) values of MNA-SF and NRS 2002 were 0.803 and 0.776, respectively. For patients with AE, NRS 2002 and MNA-SF results correlated well with ESPEN (k = 0.555, 0.493). AUC values of NRS 2002 and MNA-SF were 0.776 and 0.792, respectively. Conclusion: This study is the first to analyze hospitalized echinococcosis patients based on these nutritional screening tools. Our results suggest that NRS 2002 and MNA-SF are suitable tools for nutritional screening of inpatients with echinococcosis.


2008 ◽  
Vol 21 (5) ◽  
pp. 589-601 ◽  
Author(s):  
Mariur Gomes Beghetto ◽  
Bibiana Manna ◽  
Andréia Candal ◽  
Elza Daniel de Mello ◽  
Carisi Anne Polanczyk

Em hospitais, o objetivo de um procedimento de triagem nutricional é identificar indivíduos desnutridos ou em risco de desnutrição, possibilitando intervenção nutricional precoce e melhor alocação de recursos. Diferentes métodos são apresentados na literatura para esta finalidade: Malnutrition Screening Tool, Short Nutritional Assessment Questionnaire, Nutritional Risk Index, Nutrition Risk Score, Nutritional Risk Screening, Mini Nutritional Assessment, Malnutrition Universal Screening Tool, Nutritional Screening Tool, Nutritional Screening Equation. No entanto, o emprego de muitos destes instrumentos está limitado pela inadequada metodologia empregada na derivação e/ou validação, pela seleção de grupos específicos de pacientes, pela pouca praticidade ou por necessidade de um especialista para seu emprego. Na ausência de um padrão de referência para emitir o diagnóstico nutricional, desfechos clínicos relevantes devem balizar a derivação e a validação de novos instrumentos. Este trabalho descreve os instrumentos de triagem nutricional acima referidos e apresenta considerações quanto ao seu emprego para adultos hospitalizados não selecionados.


Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1306 ◽  
Author(s):  
Julia Traub ◽  
Ina Bergheim ◽  
Angela Horvath ◽  
Vanessa Stadlbauer

Malnutrition in liver cirrhosis is frequently underestimated. To determine if a patient is at risk of malnutrition, several screening tools have been established. However, most of them are not validated for patients with liver cirrhosis. Therefore, we compared the RFH-NPT (Royal Free Hospital Nutritional Prioritizing Tool) as the validated gold standard for malnutrition screening in cirrhosis patients with GMS (Graz Malnutrition Screening), NRS-2002 (Nutritional Risk Screening) and MNA-SF (Mini Nutritional Assessment-Short Form). Based on common validity criteria for screening tools, only the MNA-SF showed fair correlation (12/15 points) with the RFH-NPT, whereas NRS-2002 and GMS performed worse (6/15 points). Taken together, our results suggest that NRS-2002 and GMS are not suitable for screening of malnutrition in cirrhosis patients. A cirrhosis-specific screening tool like RFH-NPT should be used to assess malnutrition and to identify those at risk of malnutrition.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1279
Author(s):  
Christina N. Katsagoni ◽  
Olga Cheirakaki ◽  
Anastasia Hatzoglou ◽  
Ourania Zerva ◽  
Alexandra Koulieri ◽  
...  

Nutritional risk screening (NRS) is not yet established in many clinical settings. This study aimed to evaluate the efficacy of two NRS tools; the Paediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), compared to the global dietitians’ clinical judgment. The goal of this study was also to estimate the prevalence of nutritional risk in Greek paediatric patients. Overall, 1506 children, 1–16 years, from paediatric and surgical wards of two Greek hospitals were included. NRS was performed using PYMS and STAMP based either on World Health Organization (WHOGC) or Hellenic growth charts (HGC). The first 907 children were also referred to dietitians who categorized children in low, medium and high nutritional risk according to their global clinical judgment. PYMS, either based on WHOGC or HGC, showed better agreement with dietitians’ feedback (kPYMS_WHO = 0.47; 95%CI: 0.41–0.52, kPYMS_HGC = 0.48; 95%CI: 0.43–0.53) compared to STAMP (kSTAMP_WHO = 0.28; 95%CI: 0.23–0.33, kSTAMP_HGC = 0.26; 95%CI: 0.21–0.32). PYMS also showed the best diagnostic accuracy compared to STAMP in paediatrics and surgical wards separately. Moreover, the PYMS showed similar sensitivity to the STAMP (WHOGC: 82% vs. 84.4%), but a higher positive predictive value (WHOGC: 58.2 vs. 38.7). Using PYMS, high and medium malnutrition risk was observed at 14.9%, and 13.1% of children, respectively. Almost 28% of hospitalised children were at nutritional risk. Children in hospitals should be screened with effective and feasible NRS tools such as PYMS.


2012 ◽  
Vol 8 (4) ◽  
pp. 188
Author(s):  
Susetyowati Susetyowati ◽  
Hamam Hadi ◽  
Muhammad Hakimi ◽  
Ahmad Husein Asdie

Background: A comprehensive nutrition assessment needs to be done on all hospitalized patients. The accuracy of nutritional assessment are necessary to ensure the provision of optimal nutrition support for the patient to prevent iatrogenic malnutrition and speed up the healing process. The nutrition screening tools has limited ability to be used as a valid indicator for comprehensive nutritional assessment. Thus, it is necessary to develop a new nutrition screening tool.Objective: To develop a simple, quick and valid malnutrition screening tool that can be used to identify adult patients at risk of malnutrition.Methods: This is an observational study with cross sectional design. The subjects were 495 patients admitted to Sardjito General Hospital, excluding paediatric, maternity, and psychiatric patients. All patients were screened using the Nutrition Screening Tool of University Gadjah Mada (NST-UGM). The validity of the NST-UGM will be tested by measuring the sensitivity and specifi city value compared to Subjective Global Assessment (SGA).Result: The newly developed nutrition screening tool consisted of 6 questions with a cut-off of 0-2 classifi ed as not at risk of malnutrition and > 2 classifi ed as at risk of malnutrition. The sensitivity and specifi city value of the new screening tool compared with SGA were 91.28 and 79.78 respectively. Therefore, the convergent and predictive validity of NSTUGM was established. Conclusion: The NST-UGM is a simple, quick and valid tool which can be used to identify patients at risk of malnutrition. 


2016 ◽  
Vol 101 (12) ◽  
pp. 1119-1124 ◽  
Author(s):  
P C Thomas ◽  
L V Marino ◽  
S A Williams ◽  
R M Beattie

IntroductionMultiple nutritional risk assessment tools are available, but there are limited data on their application in the acute setting. We explored the validity of two tools in a tertiary Children's Hospital's acute unit and the cohort's nutritional status using WHO definitions.MethodsProspective study n=300 (median 38 months; 44.6% female; 25.7% ≤12 months). Participants had standard anthropometry measured, all were screened using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), the Paediatric Malnutrition Screening Tool (PMST) (modified STAMP) and 125 were additionally screened using the Paediatric Yorkhill Malnutrition Screening (PYMS) tool.ResultsThe percentages with medium/high nutritional risk were as follows: STAMP 73.1%, PMST 79.3% and PYMS 30%. Height/weight were normally distributed with: 3.4% stunted (height-for-age z-score <−2); aged ≤ 5 years, 6.8% wasted (weight-for-height z-score (WHZ) <−2), 17.9% overweight (WHZ 1–2) and 6.2% obese (WHZ >2); aged >5 years, 5.8% thin (body mass index (BMI)-z-score (BAZ) <−2), 17.3% overweight (BAZ 1–2) and 5.8% obese (BAZ >2). The tools showed poor specificity and variable sensitivities when compared with WHO malnutrition criteria, with positive predictive values of <50%. κ-Analysis also showed poor agreement between the tools and the WHO cut-offs.ConclusionThese results suggest that nutritional screening tools have poor sensitivity and are difficult to interpret in the acute setting. It may be more effective to include the assessment of weight and height and nutritional intake in the context of the acute presentation as part of routine clinical assessment rather than relying on screening tools to identify those at risk.


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