Abstract Objective To investigate the nutritional status of children with cerebral palsy (CP) and the clinical effectiveness of Subjective Global Nutritional Assessment (SGNA) in nutritional assessment of hospitalized children with CP. Methods A total of 208 children with CP, aged 1-5 years, who were hospitalized from April to October 2019 were enrolled as subjects. SGNA was used to investigate nutritional status, and the Z-score method recommended by the World Health Organization was used as a reference standard to validate the clinical effectiveness of SGNA. Results The detection rate of malnutrition in children with CP was 42.3% by SGNA and 39.4% by the Z-score method (P > 0.05). The application of SGNA showed high consistency between different evaluators (κ=0.621, P < 0.001). With the Z-score method as the reference standard, SGNA had a sensitivity of 80.5%, a specificity of 82.5%, a positive predictive value of 75.0%, and a negative predictive value of 86.7%, and high consistency was observed between the two evaluation methods (κ=0.622, P < 0.001). SGNA was moderately consistent with weight-for-age Z-score and height-for-age Z-score (κ=0.495 and 0.478 respectively, P < 0.001) and was poorly consistent with weight-for-height Z-score (κ=0.197, P < 0.05). Conclusions There is a relatively high incidence rate of malnutrition in children with CP. SGNA can be used as a tool to assess the nutritional status of children with CP.
LIU Han-You,ZHU Deng-Na,CHEN Gong-Xun et al. Clinical effectiveness of Subjective Global Nutritional Assessment in hospitalized children with cerebral palsy[J]. CJCP, 2020, 22(11): 1188-1192.
LIU Han-You,ZHU Deng-Na,CHEN Gong-Xun et al. Clinical effectiveness of Subjective Global Nutritional Assessment in hospitalized children with cerebral palsy[J]. CJCP, 2020, 22(11): 1188-1192.
Bell KL, Benfer KA, Ware RS, et al. Development and validation of a screening tool for feeding/swallowing difficulties and undernutrition in children with cerebral palsy[J]. Dev Med Child Neurol, 2019, 61(10):1175-1181.
Penagini F, Mameli C, Fabiano V, et al. Dietary intakes and nutritional issues in neurologically impaired children[J]. Nutrients, 2015, 7(11):9400-9415.
[8]
Aydin K, Turkish Cerebral Palsy Study Group. A multicenter cross-sectional study to evaluate the clinical characteristics and nutritional status of children with cerebral palsy[J]. Clin Nutr ESPEN, 2018, 26:27-34.
[9]
Mallawaarachchi S, Jayatissa R, Jagoda J, et al. MON-PO593:nutrition status of children with cerebral palsy:usefulness of new us cerebral palsy growth chart[J]. Clin Nutr, 2019, 38(Suppl 1):S279.
[10]
Martínez de Zabarte Fernández JM, Ros Arnal I, Peña Segura JL, et al. Nutritional status of a population with moderate-severe cerebral palsy:beyond the weight[J]. An Pediatr (Barc), 2020, 92(4):192-199.
[11]
Rempel G. The importance of good nutrition in children with cerebral palsy[J]. Phys Med Rehabil Clin N Am, 2015, 26(1):39-56.
[12]
Dipasquale V, Gottrand F, Sullivan PB, et al. Top-ten tips for managing nutritional issues and gastrointestinal symptoms in children with neurological impairment[J]. Ital J Pediatr, 2020, 46(1):35.
[13]
Romano C, van Wynckel M, Hulst J, et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment[J]. J Pediatr Gastroenterol Nutr, 2017, 65(2):242-264.
[14]
Secker DJ, Jeejeebhoy KN. Subjective Global Nutritional Assessment for children[J]. Am J Clin Nutr, 2007, 85(4):1083-1089.
[15]
Secker DJ, Jeejeebhoy KN. How to perform Subjective Global Nutritional Assessment in children[J]. J Acad Nutr Diet, 2012, 112(3):424-431.e6.
[16]
WHO Multicentre Growth Reference Study Group. WHO child growth standards based on length/height, weight and age[J]. Acta Paediatr Suppl, 2006, 95(S450):76-85.
[17]
Madden A. Anthropometric standards:an interactive nutritional reference of body size and body composition for children and adults[J]. J Hum Nutr Diet, 2009, 22(3):255.
[18]
Samson-Fang L, Bell KL. Assessment of growth and nutrition in children with cerebral palsy[J]. Eur J Clin Nutr, 2013, 67(Suppl 2):S5-S8.
[19]
Scarpato E, Staiano A, Molteni M, et al. Nutritional assessment and intervention in children with cerebral palsy:a practical approach[J]. Int J Food Sci Nutr, 2017, 68(6):763-770.
[20]
Karim T, Jahan I, Dossetor R, et al. Nutritional status of children with cerebral palsy-findings from prospective hospital-based surveillance in Vietnam indicate a need for action[J]. Nutrients, 2019, 11(9):2132.
Minocha P, Sitaraman S, Choudhary A, et al. Subjective Global Nutritional Assessment:a reliable screening tool for nutritional assessment in cerebral palsy children[J]. Indian J Pediatr, 2018, 85(1):15-19.
[23]
Vermilyea S, Slicker J, El-Chammas K, et al. Subjective Global Nutritional Assessment in critically ill children[J]. JPEN J Parenter Enteral Nutr, 2013, 37(5):659-666.
