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住院儿童和青少年的营养状况:两种含人体测量参数的营养评估工具的比较

THE NUTRITIONAL STATUS OF HOSPITALIZED CHILDREN AND ADOLESCENTS: A COMPARISON BETWEEN TWO NUTRITIONAL ASSESSMENT TOOLS WITH ANTHROPOMETRIC PARAMETERS.

作者信息

Oliveira Thaynara Cristina de, Albuquerque Izabela Zibetti de, Stringhini Maria Luiza Ferreira, Mortoza Andrea Sugai, Morais Bruna Alves de

机构信息

Universidade Federal de Goiás, Goiânia, GO, Brasil.

出版信息

Rev Paul Pediatr. 2017 Jul-Sep;35(3):273-280. doi: 10.1590/1984-0462/;2017;35;3;00006. Epub 2017 Jul 31.

Abstract

OBJECTIVE

Verify the association between anthropometric indicators and the Subjective Global Assessment of Nutritional Status (SGA) and the Screening of Risk for Nutritional Status and Growth (STRONGkids) scales.

METHODS

A cross-sectional study with patients from 0 to 18 years admitted in the Hospital das Clínicas, Goiânia (GO), between August and November 2015. Children and adolescents admitted in up to 48 hours were included. Patients who required specific instruments for assessing their nutritional status and those hospitalized in Intensive Care were excluded. Identification and anthropometric data was collected and applied to the SGA and STRONGkids. We performed an analysis comparing proportions and did an agreement assessment, where p<0.05 was significant.

RESULTS

71 patients were evaluated, of whom 9.6% had low or very low birth weight/age, 9.7% had thinness or accentuated thinness according to the weight/height index, 16.9% had a height impairment, 7% were thin according to the body mass index/age, and 32.4% were malnourished with regard to arm muscle circumference. The STRONGkids detected that 69% of the sample had a moderate or high nutritional risk. According to the SGA, malnutrition prevalence was 38.1%. There was an association between the SGA and body mass index/age (p=0.022), height/age (p<0.001) and arm muscle circumference (p=0.014). There was no association between the STRONGkids and anthropometric indicators. A correlation was found between: high nutritional risk versus severe malnutrition and low nutritional risk x the well-nourished (p<0.001), but the agreement was weak (k=0.255).

CONCLUSIONS

It is recommended to use the STRONGkids as a screening instrument because it has a higher sensitivity for diagnosing patients with a nutritional risk. The SGA should be applied to nutritional assessment due to its association with anthropometry.

摘要

目的

验证人体测量指标与主观全面营养状况评估(SGA)以及营养状况与生长风险筛查(STRONGkids)量表之间的关联。

方法

于2015年8月至11月在戈亚尼亚(GO)的临床医院对0至18岁的患者进行了一项横断面研究。纳入入院时间不超过48小时的儿童和青少年。排除需要特定仪器评估营养状况的患者以及入住重症监护病房的患者。收集识别信息和人体测量数据,并应用于SGA和STRONGkids评估。我们进行了比例比较分析并进行了一致性评估,其中p<0.05具有统计学意义。

结果

共评估了71例患者,其中9.6%出生体重/年龄低或极低,9.7%根据体重/身高指数消瘦或严重消瘦,16.9%身高受损,7%根据体重指数/年龄消瘦,32.4%臂肌围度存在营养不良。STRONGkids检测发现69%的样本存在中度或高度营养风险。根据SGA,营养不良患病率为38.1%。SGA与体重指数/年龄(p=0.022)、身高/年龄(p<0.001)和臂肌围度(p=0.014)之间存在关联。STRONGkids与人体测量指标之间无关联。发现高营养风险与严重营养不良以及低营养风险与营养良好之间存在相关性(p<0.001),但一致性较弱(k=0.255)。

结论

建议使用STRONGkids作为筛查工具,因为它对诊断有营养风险的患者具有更高的敏感性。由于SGA与人体测量学相关联,应将其应用于营养评估。

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