Screening for nutritional risk in hospitalized children: comparison of two instruments
Abstract: Malnutrition in
hospitalized children has negative impact on morbidity, mortality, length of
stay, and health-care cost. A simple screening tool is needed to detect
hospital malnutrition risk in children.
Objective To compare the level of agreement of the Screening Tool for
Malnutrition in Pediatrics (STAMP) and Pediatric Nutritional Risk Score (PNRS)
with anthropometric measurements, as screening tools for hospital malnutrition
in children.
Methods A cross-sectional study was conducted from February to July 2014
in the Pediatric and Surgery Wards at H. Adam Malik Hospital, Medan, North
Sumatera. Inclusion criteria were children aged 2 to 18 years who were
hospitalized for more than 72 hours. Subjects were screened using STAMP and
PNRS, and underwent anthropometric measurement on admission. The weight
measurements were repeated on the 3rd and 7th days, and just before discharge.
The STAMP and PNRS results were compared in terms of level of agreement with
anthropometric measurements. Data were analyzed by Kappa value and Spearman’s
correlation test.
Results A total of 127 children were screened with both instruments. The
PNRS had slight agreement with hospital malnutrition prevalence (κ=0.175;
P=0.028), while STAMP had not (κ=0.080;
P=0.193). Both screening tools had weak positive correlations with length of
stay, but the correlation was stronger for PNRS than for STAMP (r=0.218;
P=0.014 vs. r=0.188; P=0.034, respectively). The prevalence of hospital
malnutrition was 40.9%.
Conclusions The PNRS screening
tool has slight agreement with anthropometric measurement for identifying
hospital malnutrition risk in children.
Keywords: hospital
malnutrition; STAMP; PNRS; anthropometric
Author: Dwi Novianti, Tiangsa
Sembiring, Sri Sofyani, Tri Faranita, Winra Pratita
Journal Code: jpkedokterangg170002
