Ege University, Faculty of Medicine, Department of Pediatric Oncology, Izmir, Turkey.
Ege University, Faculty of Medicine, Department of Pediatric Oncology, Izmir, Turkey.
Nutrition. 2021 Jun;86:111142. doi: 10.1016/j.nut.2021.111142. Epub 2021 Jan 10.
The aim of this study was to determine the prevalence of malnutrition, to compare nutritional evaluation tools, and to highlight the importance of nutritional status in pediatric oncology patients.
This study evaluated the nutritional status, based on height, weight, and midupper arm circumference, of 170 patients ages 5 months to 18 years who were hospitalized at the Ege University Hospital Pediatric Oncology Clinic. The prevalence of malnutrition was determined using the malnutrition screening tools, STRONGkids (SK) and Pediatric Yorkhill Malnutrition Score (PYMS). Correlations, sensitivity, specificity, and the positive and negative predictive values between the screening tools were calculated.
In all, 68.2% of the patients were diagnosed with a solid tumor. According to SK, 59.4% had a moderate risk of malnutrition, and 40.6% had a high risk. According to PYMS, 30.6% of patients had a low to moderate risk of malnutrition, and 69.4% had a high risk of malnutrition. Minimal agreement was noted between SK and PYMS (Kappa value: 0.40 and 0.18, respectively). The sensitivity of PYMS was higher than that of SK (92.68 and 78.05, respectively). In total, 22.9% of the patients had a body mass index of <5%, and 21.2% had a midupper arm circumference of <5.
The present findings show that, in general, pediatric oncology patients have a high risk of malnutrition. Although SK and PYMS do not differ significantly, PYMS has higher sensitivity for detecting malnutrition. The nutritional status of pediatric oncology patients should be monitored using appropriate screening techniques throughout their treatment.
本研究旨在确定营养不良的患病率，比较营养评估工具，并强调儿科肿瘤患者营养状况的重要性。
本研究通过身高、体重和上臂中部周径评估了在伊兹密尔大学医院儿科肿瘤科住院的 170 名 5 个月至 18 岁的患者的营养状况。使用营养不良筛查工具 STRONGkids（SK）和儿科约克希尔营养不良评分（PYMS）确定营养不良的患病率。计算了筛查工具之间的相关性、敏感性、特异性以及阳性和阴性预测值。
所有患者中，68.2%的患者被诊断为实体瘤。根据 SK，59.4%的患者有中度营养不良风险，40.6%的患者有高度营养不良风险。根据 PYMS，30.6%的患者有低中度营养不良风险，69.4%的患者有高度营养不良风险。SK 和 PYMS 之间的一致性较低（Kappa 值分别为 0.40 和 0.18）。PYMS 的敏感性高于 SK（分别为 92.68%和 78.05%）。总的来说，22.9%的患者 BMI<5%，21.2%的患者上臂中部周径<5。
本研究结果表明，一般来说，儿科肿瘤患者有很高的营养不良风险。尽管 SK 和 PYMS 没有显著差异，但 PYMS 检测营养不良的敏感性更高。应使用适当的筛查技术监测儿科肿瘤患者的营养状况，贯穿整个治疗过程。
