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- Title
Development and validation of a pediatric nutritional screening score (PNSS) for hospitalized children.
- Authors
Lu, Lina; Xiaomeng Mao; Jinye Sheng; Jianhu Huang; Ying Wang; Qingya Tang; Wei Cai; Mao, Xiaomeng; Sheng, Jinye; Huang, Jianhu; Wang, Ying; Tang, Qingya; Cai, Wei
- Abstract
<bold>Background and Objectives: </bold>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.<bold>Methods and Study Design: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>PNSS is the first nutritional screening tool developed for hospitalized children and validated in a large population of patients in China.
- Subjects
CHINA; MALNUTRITION risk factors; PEDIATRICS; WEIGHT loss -- Risk factors; HOSPITAL admission &; discharge; NUTRITION; PATIENTS; PHYSIOLOGY; ANTHROPOMETRY; HOSPITAL care of children; EXPERIMENTAL design; LONGITUDINAL method; RESEARCH methodology; NUTRITIONAL assessment; SCIENTIFIC observation; INTER-observer reliability; RESEARCH methodology evaluation; CHILDREN
- Publication
Asia Pacific Journal of Clinical Nutrition, 2018, Vol 27, Issue 1, p65
- ISSN
0964-7058
- Publication type
journal article
- DOI
10.6133/apjcn.032017.17