Meral Buket, Kangalgil Melda, Erduran Erol
Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey.
Department of Nutrition and Dietetics, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey.
J Pediatr Nurs. 2025 Jan-Feb;80:154-160. doi: 10.1016/j.pedn.2024.11.009. Epub 2024 Nov 29.
Malnutrition in pediatric oncology patients is a complex and multifactorial process, and the most appropriate screening tool to determine the risk of malnutrition is not clear. The study aimed to compare the Screening Tool for Risk on Nutritional Status and Growth (StrongKids), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), which are commonly used in the general pediatric population, with the Nutrition Screening Tool for Childhood Cancer (SCAN), which was specifically validated for pediatric cancer, in determining the risk of malnutrition.
This cross-sectional study included 92 children aged 2-18 years who were admitted to the hematology-oncology unit and were receiving chemotherapy. The prevalence of nutritional risk was determined using the SCAN, StrongKids, PYMS, STAMP, and anthropometric assessments were performed. Sensitivity and specificity values, and the degree of agreement between screening tools were calculated.
The SCAN identified nutritional risk in 69.6 % of the children. According to StrongKids, PYMS and STAMP, the high nutritional risk in children was 43.5 %, 56.5 % and 64.1 %, respectively. The sensitivity of STAMP (81.2 %) was higher than that of StrongKids (60.9 %) and PYMS (79.7 %). The specificity of StrongKids, PYMS and STAMP was 96.4 %, 96.4 %, and 75.0 %, respectively. There was substantial agreement between SCAN and PYMS.
PYMS has the best specificity and sensitivity in identifying patients at risk of malnutrition as determined by SCAN.
In addition to anthropometric measurements, population-specific or highly sensitive nutritional screening tools should be used to determine the risk of malnutrition.
儿科肿瘤患者的营养不良是一个复杂的多因素过程,目前尚不清楚用于确定营养不良风险的最合适筛查工具。本研究旨在比较一般儿科人群常用的营养状况和生长风险筛查工具(StrongKids)、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)与专门针对儿科癌症验证的儿童癌症营养筛查工具(SCAN)在确定营养不良风险方面的差异。
这项横断面研究纳入了92名年龄在2至18岁之间、入住血液肿瘤科并正在接受化疗的儿童。使用SCAN确定营养风险患病率,并进行StrongKids、PYMS、STAMP评估以及人体测量评估。计算了敏感性和特异性值以及筛查工具之间的一致性程度。
SCAN确定69.6%的儿童存在营养风险。根据StrongKids、PYMS和STAMP评估,儿童高营养风险分别为43.5%、56.5%和64.1%。STAMP的敏感性(81.2%)高于StrongKids(60.9%)和PYMS(79.7%)。StrongKids、PYMS和STAMP的特异性分别为96.4%、96.4%和75.0%。SCAN和PYMS之间存在高度一致性。
在确定SCAN所定义的营养不良风险患者方面,PYMS具有最佳的特异性和敏感性。
除人体测量外,应使用针对特定人群或高敏感性的营养筛查工具来确定营养不良风险。