Evaluation of Nutritional Risk Screening Tool among Hospitalized Infants and Children in Pediatric Hospital of Ain Shams University

Abstract

The aim of this work was to evaluate the use of STRONGkids as a simple and useful nutrition screening tool for hospitalized children to address the risk of malnutrition during their hospital stay. This study was conducted on 300 newly hospitalized infants and children who were recruited from the Pediatric Hospital, Ain Shams University from the period from January the 1st 2014 to August 29th, 2014. They were 147 males and 153 females and their ages ranged between 5 and 108 months with a mean age of 38.56 ± 26.11 months. We included patients more than 1 month of age with an expected stay in hospital of at least five day in a pediatric ward and we excluded intensive care patients. The reasons for admission were recorded as respiratory, trauma, infectious, surgical, oncological, gastro-intestinal, cardiac, and neurological and others. All infants and children were subjected to history taking, physical examination and assessment of nutritional status and nutritional risk factors using Nutritional risk screening tool STRONGkids (Screening Tool for Risk on Nutritional status and Growth which was performed in Dutch hospitals)andAnthropometric measurements including Weight measurement on admission, and at discharge, Supine length or standing height, Mid upper arm circumference, Triceps skinfold thickness and Body mass index. All anthropometric data was compared with published standards of the WHO 2006 and translated into z scores. The study revealed that: - Among studied patients, 144 (48%) patients had acute disease and 156 (52%) had chronic disease. - The most common cause of admission in our study was respiratory system affection (23%). - According to STRONGkids score, patients were classified into 55 (18.3%) of patients had low risk (with 0 points), 139 (46.3%) had moderate risk (1-3 points) and 106 (35.4%) had high risk (4-5 points). - Patients with Renal system affection have significant higher age compared to those suffering from other disorders. Meanwhile, patients with oncological disorders have significant lower ages compared to those suffering from other disorders. - The duration of hospital stay is significantly higher among patients with Oncological, Cardiac, Renal and Hepatic Disorders compared to others. - The mean values of STRONGkids score were significantly higher among patients with Oncological and neurological followed by hepatic, Cardiac and GIT patients compared to those with other disorders. - The mean values of Z score of change of weightwere significantly higher among patients with Oncological followed by those with hepatic, neurological and GIT compared to those with other disorders. - The mean values of Z score of weight-for-height on admissionwere significantly lower among patients with neurological, oncological and hepatic disorders compared to those with other disorders. - The mean values of Z score of weight-for-height on dischargewere significantly lower among patients with oncological disorders followed by those with GIT, Hepatic and Renal disorders followed by those with respiratory, surgical, neurological and cardiac disorders. - The mean values of Z score of change of weight-for-height were significantly lower among patients with oncological and hepatic disorders followed by those with neurological and cardiac disorders compared to others. - The mean values of Z score of BMI were significantly lower among patients with oncological and hepatic disorders followed by those with neurological, GIT and cardiac disorders compared to others. - STRONGkids score values were significantly positively correlated with the duration of hospital stay. - STRONGkids score values were significantly negatively correlated with the values of weight on admission, weight on discharge, height, triceps skin fold thickness, weight-for-height on discharge and BMI. - STRONGkids score values were significantly negatively correlated with both z scores of changes in weight and changes of weight-for-height.