Nutritional risk assessment in hospitalized children: a comparison of pediatric subjective global assessment and STRONGkids screening tool with anthropometric indicators

Aims: To compare the Subjective Global Nutritional Assessment (SGNA) and the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) protocols with anthropometric measurements at admission, and associate them to length of stay in hospitalized children. Methods: Cross-sectional study with patients from four to 8.9 years admitted to a pediatric hospital in Porto Alegre, Rio Grande do Sul, Brazil. The sample was selected by convenience, and data collection occurred between June and October 2014. Patients in the Intensive Care Unit and those unable to feed orally were not included. We collected general and socioeconomic information and applied STRONGkids and SGNA protocols at admission. Clinical and anthropometric data were retrieved from electronic medical records. Results: We evaluated 317 patients with a mean age of 76.1±17.5 months, most of them admitted for surgery (21.5%). According to anthropometric measurements, 5% of patients were malnourished, 74.1% had normal weight and 20.8% were overweight. There was a statistically significant association between malnutrition classified by anthropometric measurements and moderate and severe malnutrition defined by SGNA (p<0.001). There was also a significant association between overweight, normal weight and malnutrition classified by anthropometric measurements and low, medium and high nutritional risk, respectively (p<0.001). There was a statistically significant agreement, although very weak, between STRONGkids and anthropometric measurements (kappa=0.148; p=0.001). Conclusions: All protocols were associated (though in low intensity) to length of hospital stay. In addition, STRONGkids showed greater agreement, although still weak, with anthropometric measurements when compared to the SGNA. Further studies are needed to verify the agreement of these protocols with other objective methods of nutritional assessment.