Sayed Shaimaa, El-Shabrawi Mortada H F, Abdelmonaem Eman, El Koofy Nehal, Tarek Sara
Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
Pediatr Gastroenterol Hepatol Nutr. 2023 Jul;26(4):213-223. doi: 10.5223/pghn.2023.26.4.213. Epub 2023 Jul 5.
Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children.
We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard.
Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS.
The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.
低收入国家的儿科患者面临着很高的营养不良风险。已经开发了许多筛查工具来检测营养不良风险,包括主观全面营养评估(SGNA)、儿科约克希尔营养不良评分(PYMS)、儿科营养不良评估筛查工具(STAMP)以及营养状况和生长风险筛查工具(STRONGkids)。然而,人体测量学仍然是评估营养不良的主要工具。我们旨在确定四种营养筛查工具相对于人体测量学在评估儿童营养状况方面的价值。
我们对1000名年龄在1至12岁、前往开罗大学儿童医院门诊就诊的儿童进行了一项横断面研究。每位参与者均使用人体测量指标(体重、身长/身高以及身长/身高对应的体重)以及PYMS、STAMP、STRONGkids和SGNA筛查工具进行评估。以人体测量学作为金标准,评估这四种工具的敏感性和特异性。
患者中,1.7%体重过轻,10.2%消瘦,35%发育迟缓。与身高对应的体重相比,STRONGkids在检测营养不良方面表现出最高的敏感性(79.4%)和较高的特异性(80.2%),其次是STAMP,其敏感性较低(73.5%)但特异性较高(81.4%)。PYMS的敏感性最低(66.7%),特异性最高(93.5%),而SAGA的敏感性高于PYMS(77.5%),特异性低于PYMS(85.4%)。
使用营养筛查工具评估儿童营养状况很有价值,建议将其作为一种识别儿科患者营养不良风险的简单快速方法。