Department of Pediatrics, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
Department of Preventive and Social Medicine, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
Indian J Pediatr. 2018 Jan;85(1):15-19. doi: 10.1007/s12098-017-2501-3. Epub 2017 Oct 12.
To determine the prevalence of undernutrition in children with cerebral palsy and to compare subjective and objective methods of nutritional assessment.
This was a hospital based analytical observational study in which 180 children of cerebral palsy, aged 1-12 y, attending tertiary level hospital, Jaipur from March, 2012 through March, 2013 were included. Subjective assessment was done by questionnaire (Subjective Global Nutritional Assessment; SGNA) in which questions related to nutrition history and physical examination, signs of fat, muscle wasting and edema was done while objective assessment was done by weight, height and triceps skinfold thickness (TSFT) measurements.
In this study prevalence of undernutrition by subjective method (SGNA) was 76.67% while by objective measurement (weight, height, TSFT) was 48.89%, 77.78% 35.18% respectively. There was fair to moderate agreement between the SGNA and objective assessments including weight and height (k = 0.341, p = 0.000; k = 0.337, p = 0.000 respectively) while for TSFT agreement between both methods was poor (k = 0.092, p = 0.190). In the index study, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SGNA was for weight was 95%, 37%, 56%, 90%; for height 84%, 50%, 85%, 47%; for TSFT 81%, 30%, 38%, 75% respectively.
The prevalence of undernutrition is high in cerebral palsy children. SGNA can be a reliable tool for assessing nutritional status in children with cerebral palsy and is a simple, comprehensive, noninvasive, and cost-effective tool for screening undernutrition in children of cerebral palsy.
确定脑瘫儿童的营养不良患病率，并比较营养评估的主观和客观方法。
这是一项基于医院的分析性观察研究，纳入了 2012 年 3 月至 2013 年 3 月在拉贾斯坦邦斋浦尔的三级医院就诊的 180 名脑瘫儿童。通过问卷调查（主观整体营养评估；SGNA）进行主观评估，其中包括与营养史和体检相关的问题、脂肪、肌肉消瘦和水肿的迹象；通过体重、身高和三头肌皮褶厚度（TSFT）测量进行客观评估。
本研究中，主观方法（SGNA）评估的营养不良患病率为 76.67%，而客观测量（体重、身高、TSFT）的患病率分别为 48.89%、77.78%和 35.18%。SGNA 与体重和身高的客观评估之间存在中等程度到适度的一致性（k=0.341，p=0.000；k=0.337，p=0.000），而 TSFT 之间的一致性较差（k=0.092，p=0.190）。在本研究中，SGNA 对体重的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为 95%、37%、56%、90%；对身高为 84%、50%、85%、47%；对 TSFT 为 81%、30%、38%、75%。
脑瘫儿童的营养不良患病率较高。SGNA 可作为评估脑瘫儿童营养状况的可靠工具，是一种简单、全面、非侵入性且具有成本效益的脑瘫儿童营养不良筛查工具。
