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Nutritional risk screening-a cross-sectional study in a tertiary pediatric hospital.

ABSTRACT: BACKGROUND:All hospitalized patients should be screened for malnutrition risk. No universal method exists for pediatric patients. METHODS:We performed a cross-sectional study comparing three published malnutrition risk screening tools (PYMS, STAMP, and STRONGkids), applying them to each inpatient aged 1?month to 17?years over a period of five consecutive weekdays in Helsinki University Hospital, Finland. RESULTS:Of the eligible patients, 67% (n?=?69) participated. We found that 6.2% of the children were acutely malnourished and accurately categorized by the three tools. STRONGkids showed the highest specificity (100%) and positive predictive value (36%). Acute malnutrition seemed to be associated with longer hospital stay (p?=?0.051). CONCLUSION:STRONGkids was the most accurate screening tool for detecting acute malnutrition and was therefore chosen as the screening method in our hospital. Routine screening for the risk of malnutrition in pediatric inpatients is important in detecting at-risk children who would otherwise be left without dietary intervention.

SUBMITTER: Tuokkola J

PROVIDER: S-EPMC6432750 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Nutritional risk screening-a cross-sectional study in a tertiary pediatric hospital.

Tuokkola J J Hilpi J J Kolho K-L KL Orell H H Merras-Salmio L L

Journal of health, population, and nutrition 20190325 1

<h4>Background</h4>All hospitalized patients should be screened for malnutrition risk. No universal method exists for pediatric patients.<h4>Methods</h4>We performed a cross-sectional study comparing three published malnutrition risk screening tools (PYMS, STAMP, and STRONG<sub>kids</sub>), applying them to each inpatient aged 1 month to 17 years over a period of five consecutive weekdays in Helsinki University Hospital, Finland.<h4>Results</h4>Of the eligible patients, 67% (n = 69) participated ...[more]

PMID: 30909976

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Project description:IntroductionSickle cell disease (SCD) remains a major cause of childhood mortality and morbidity in Malawi. However, literature to comprehensively describe the disease in the paediatric population is lacking.MethodsA retrospective review of clinical files of children with SCD was conducted. Descriptive statistics were performed to summarise the data. χ2 or Fisher's exact test was used to look for significant associations between predictor variables and outcome variables (case fatality and length of hospital stay). Predictor variables that were significantly associated with outcome variables (p≤0.05) in a χ2 or Fisher's exact test were carried forward for analysis in a binary logistic regression. A multivariable binary logistic regression was used to identify covariates that independently predicted length of hospital stay.ResultsThere were 16 333 paediatric hospitalisations during the study period. Of these, 512 were patients with SCD representing 3.1% (95% CI: 2.9%- 3.4%). Sixty-eight of the 512 children (13.3%; 95% CI: 10.5% - 16.5%) were newly diagnosed cases. Of these, only 13.2% (95% CI: 6.2% - 23.6%) were diagnosed in infancy. Anaemia (94.1%), sepsis (79.5%) and painful crisis (54.3%) were the most recorded clinical features. The mean values of haematological parameters were as follows: haemoglobin (g/dL) 6.4 (SD=1.9), platelets (×109/L) 358.8 (SD=200.9) while median value for white cell count (×109/L) was 23.5 (IQR: 18.0-31.2). Case fatality was 1.4% (95% CI: 0.6% - 2.8%)and 15.2% (95% CI: 12.2% -18.6%) of the children had a prolonged hospital stay (>5 days). Patients with painful crisis were 1.7 (95% CI: 1.02 - 2.86) times more likely to have prolonged hospital stay than those without the complication.ConclusionAnaemia, sepsis and painful crisis were the most common clinical features paediatric patients with SCD presented with. Patients with painful crisis were more likely to have prolonged hospital stay. Delayed diagnosis of SCD is a problem that needs immediate attention in this setting. Although somewhat encouraging, the relatively low in-hospital mortality among SCD children may under-report the true mortality from the disease considering community deaths and deaths occurring before SCD diagnosis is made.

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Nutritional risk screening-a cross-sectional study in a tertiary pediatric hospital.

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Nutritional risk screening-a cross-sectional study in a tertiary pediatric hospital.

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