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Use of standardized body composition measurements and malnutrition screening tools to detect malnutrition risk and predict clinical outcomes in children with chronic conditions.
- Source :
- American Journal of Clinical Nutrition; Dec2020, Vol. 112 Issue 6, p1456-1467, 12p, 7 Charts, 2 Graphs
- Publication Year :
- 2020
-
Abstract
- Background Better tools are needed to diagnose and identify children at risk of clinical malnutrition. Objectives We aimed to compare body composition (BC) and malnutrition screening tools (MSTs) for detecting malnutrition on admission; and examine their ability to predict adverse clinical outcomes [increased length of stay (LOS) and complications] in complex pediatric patients. Methods This was a prospective study in children 5–18 y old admitted to a tertiary pediatric hospital (n  = 152). MSTs [Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids)] were completed on admission. Weight, height, and BC [fat mass (FM) and lean mass (LM) by DXA] were measured (n  = 118). Anthropometry/BC and MSTs were compared with each other and with clinical outcomes. Results Subjects were significantly shorter with low LM compared to reference data. Depending on the diagnostic criteria used, 3%–17% were classified as malnourished. Agreement between BC/anthropometric parameters and MSTs was poor. STAMP and STRONGkids identified children with low weight, LM, and height. PYMS, and to a lesser degree STRONGkids, identified children with increased LOS, as did LM compared with weight or height. Patients with complications had lower mean ± SD LM SD scores (−1.38 ± 1.03 compared with −0.74 ± 1.40, P  < 0.05). In multivariable models, PYMS high risk and low LM were independent predictors of increased LOS (OR: 3.76; 95% CI: 1.36, 10.35 and OR: 3.69; 95% CI: 1.24, 10.98, respectively). BMI did not predict increased LOS or complications. Conclusions LM appears better than weight and height for predicting adverse clinical outcomes in this population. BMI was a poor diagnostic parameter. MSTs performed differently in associations to BC/anthropometry and clinical outcomes. PYMS and LM provided complementary information regarding LOS. Studies on specific patient populations may further clarify the use of these tools and measurements. [ABSTRACT FROM AUTHOR]
- Subjects :
- MALNUTRITION diagnosis
MALNUTRITION
ANTHROPOMETRY
BODY composition
CHRONIC diseases
CONFIDENCE intervals
LENGTH of stay in hospitals
LONGITUDINAL method
EVALUATION of medical care
MULTIVARIATE analysis
NUTRITIONAL assessment
BODY mass index
DESCRIPTIVE statistics
ODDS ratio
DISEASE risk factors
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 112
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- American Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 147531358
- Full Text :
- https://doi.org/10.1093/ajcn/nqaa142