A Retrospective Comparison between the PNST and other Paediatric Nutritional Screening Tools

Authors

  • Andrew S. Day Department of Paediatrics, University of Otago/Christchurch, Christchurch School of Medicine, PO Box 4345, Christchurch 8041
  • Vesal Moeeni Department of Paediatrics, University of Otago/Christchurch, Christchurch School of Medicine, PO Box 4345, Christchurch 8041
  • Tony Walls Department of Paediatrics, University of Otago/Christchurch, Christchurch School of Medicine, PO Box 4345, Christchurch 8041

DOI:

https://doi.org/10.6000/1929-4247.2018.07.03.1

Keywords:

Malnutrition, Nutritional risk screening, paediatrics, children, hospital admission.

Abstract

Background: Although it is widely acknowledged that hospitalized children are at greater risk of malnutrition, the available paediatric Nutritional Risk Screening (NRS) tools have not yet become universally used to identify those children at greater risk. Furthermore, the utility of one NRS tool over another remains unclear.

Materials and Methods: The utility of a recently developed tool, the Paediatric Nutritional Screening Tool (PNST), was evaluated using data previously collected in the assessment of three other NRS tools in 281 children from Iran and New Zealand. The sensitivity and specificity of each tool was then assessed based on the WHO criteria for malnutrition.

Results: The PNST recognized about half of the malnourished patients while the other three tools identified at least 85% of these children. The sensitivity of PNST for moderate (BMI-z < 2) and severe malnutrition (BMI-z <-3) was 37% and 46% respectively, while the sensitivity for other three NRS tools ranged from 82-100%.

Conclusion: In this data set, the PNST tool did not perform as well as the three more established NRS tools. Further work is required to provide optimal tools for the identification of hospitalized children at risk of malnutrition.

References

[1] Malnutrition. The Starvelings [Internet] [updated 2008 Jan 24; cited 2018 Mar 6. Available from: http://www.economist.com/ world/international/displaystory.cfm?story_id=10566634.
[2] McCarthy H, Dixon M, Crabtree I, Eaton-Evans MJ, McNulty H. The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) for use by healthcare staff. J Hum Nutr Diet 2012; 25: 311-8.
https://doi.org/10.1111/j.1365-277X.2012.01234.x
[3] Hulst JM, Zwart H, Hop WC, Joosten KFM. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children. Clin Nutr 2010; 29: 106-11.
https://doi.org/10.1016/j.clnu.2009.07.006
[4] Nutrition Tool Steering Group Women and Children's Directorate. Paediatric Yorkhill Malnutrition Score (PYMS) information and user's guide. Glasgow: NHS Greater Glasgow and Clyde 2009.

[5] White M, Lawson K, Ramsey R, et al. A simple nutritional screening tool for pediatric inpatients. J Parenter Enter Nutr 2016; 40: 392-8.
https://doi.org/10.1177/0148607114544321
[6] Moeeni V, Walls T, Day AS. Assessment of nutritional status and nutritional risk in hospitalised Iranian children. Acta Paediatr 2012; 101: e446-51.
https://doi.org/10.1111/j.1651-2227.2012.02789.x
[7] Moeeni V, Walls T, Day AS. Nutritional status and nutrition risk screening in hospitalized children in New Zealand. Acta Paediatr 2013; 102: e419-23.
https://doi.org/10.1111/apa.12299
[8] World Health Organisation. The WHO Child Growth Standards [Internet] 2007 [cited 2018 Feb 5]. Available from: http://www.who.int/childgrowth/en/
[9] Center for Disease Control and prevention. Obesity and Overweight for Professionals: Childhood: Basics [Internet] 2012 [updated 2012 Apr 27; cited 2018 Feb 14. Available from: http://www.cdc.gov/obesity/childhood/basics.html.
[10] Gerasimidis K, Macleoda I, Macleana A, et al. Performance of the novel Paediatric Yorkhill Malnutrition Score (PYMS) in hospital practice. Clin Nutr 2011; 30: 430-5.
https://doi.org/10.1016/j.clnu.2011.01.015

[11] McCarthy H, McNulty H, Dixon M, Eaton-Evans MJ. Screening for nutrition risk in children: the validation of a new tool. J Hum Nutr Diet 2008; 21: 395-6.
https://doi.org/10.1111/j.1365-277X.2008.00881_31.x
[12] McCarthy H. STAMP instruction [Internet] 2008 [updated 2010 June]. [cited 2018 Feb 5]. Available from: http://www.stampscreeningtool.org/help/index.html
[13] Huysentruyt KM, Alliet P, Muyshont L, et al. The STRONGkids nutritional screening tool in hospitalized children: A validation study. Nutrition 2013; 29: 1356-61.
https://doi.org/10.1016/j.nut.2013.05.008
[14] Gerasimidis K, Keane O, Macleod I, Flynn DM, Wright CM. A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital. Br J Nutr 2010; 104: 751-6.
https://doi.org/10.1017/S0007114510001121
[15] Chourdakis M, Hecht C, Gerasimidis K, et al. Malnutrition risk in hospitalized children: use of 3 screening tools in a large European population. Am J Clin Nutr 2016; 103: 1301-10.
https://doi.org/10.3945/ajcn.115.110700
[16] Hartman C, Shamir R, Hecht C, B K. Malnutrition screening tools for hospitalized children. Curr Opin Clin Nutr Metab Care 2012; 15: 303-9.
https://doi.org/10.1097/MCO.0b013e328352dcd4

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Published

2018-09-18

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General Articles