Abstract:Objective To study the clinical application of the modified nutritional risk screening tool and nutrition assessment in pediatric patients in China, and to provide a theoretical basis for establishing a standardized nutritional management process for pediatric patients. Methods A retrospective analysis was performed for the nutritional risk screening and nutrition assessment data of 16 249 hospitalized children. According to the degree of nutritional risk, the children were divided into a high nutritional risk group with 588 children, a moderate nutritional risk group with 4 330 children, and a non-nutritional risk group with 11 331 children. Nutrition assessment results were compared between groups. The composition of nutritional risk screening scores and the impact of nutritional risk screening on the rate of nutrition support therapy were analyzed. Results The incidence rate of nutritional risk was 30.27% (4 918/16 249), and the incidence rates of malnutrition and overnutrition were 27.37% (4 448/16 249) and 11.29% (1 834/16 249), respectively. Nutrition assessment results were significantly correlated with nutritional risk (≥ 5 years old:rs=0.313, P < 0.05; < 5 years old:rs=-0.304, P < 0.05). There was a significant difference in the composition of scoring items between the groups with different nutritional risks (P < 0.05). With the implementation of nutritional risk screening, there was a gradual increase in the rate of nutrition support therapy year by year (P < 0.05). Conclusions There is a high incidence rate of nutritional risk in hospitalized children. The use of the modified pediatric nutritional risk screening tool can promote the implementation of standardized nutritional management.
LI Xin-Yi,HUANG Sheng,ZHOU Hong-Min et al. Clinical application of the modified pediatric nutritional risk screening tool[J]. CJCP, 2021, 23(2): 186-191.
Lu L, Mao X, Sheng J, et al. Development and validation of a Pediatric Nutritional Screening Score (PNSS) for hospitalized children[J]. Asia Pac J Clin Nutr, 2018, 27(1):65-71.
Mehta NM, Skillman HE, Irving SY, et al. Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient:Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition[J]. JPEN J Parenter Enteral Nutr, 2017, 41(5):706-742.
[11]
Becker P, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition:indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition)[J]. Nutr Clin Pract, 2015, 30(1):147-161.
[12]
Barlow SE, Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity:summary report[J]. Pediatrics, 2007, 120(Suppl 4):S164-S192.
[13]
World Health Organization. WHO child growth standards:length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age:methods and development[EB/OL]. (2006)[2020-09-20]. https://apps.who.int/iris/handle/10665/43413.
[14]
World Health Organization. BMI-for-age (5-19 years)[EB/OL]. (2007)[2020-09-20]. https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age.
Cramér H. Mathematical Methods of Statistics[M]. Princeton:Princeton University Press, 1946:282.
[17]
White M, Lawson K, Ramsey R, et al. Simple nutrition screening tool for pediatric inpatients[J]. JPEN J Parenter Enteral Nutr, 2016, 40(3):392-398.
[18]
Wong Vega M, Beer S, Juarez M, et al. Malnutrition risk in hospitalized children:a descriptive study of malnutrition-related characteristics and development of a pilot pediatric risk-assessment tool[J]. Nutr Clin Pract, 2019, 34(3):406-413.
[19]
Patel V, Romano M, Corkins MR, et al. Nutrition screening and assessment in hospitalized patients:a survey of current practice in the United States[J]. Nutr Clin Pract, 2014, 29(4):483-490.
Schuetz P, Fehr R, Baechli V, et al. Individualised nutritional support in medical inpatients at nutritional risk:a randomised clinical trial[J]. Lancet, 2019, 393(10188):2312-2321.
Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute guideline on initial management of acute pancreatitis[J]. Gastroenterology, 2018, 154(4):1096-1101.