Paixão Isabela Barroso, Carvalho Beatriz Pereira de, Murad Luana Dalbem, Saraiva Danúbia da Cunha Antunes
Dietitian. Multiprofessional Residency Program in Oncology of the National Cancer Institute (INCA), Pr. da Cruz Vermelha, 23 - Centro, Rio de Janeiro, RJ, 20230-130, Brazil.
Dietitian. Nutrition Institute, State University of Rio de Janeiro (UERJ), Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 20559-900, Rio de Janeiro, Brazil.
Clin Nutr ESPEN. 2025 Aug;68:47-54. doi: 10.1016/j.clnesp.2025.04.007. Epub 2025 Apr 24.
BACKGROUND & AIMS: In cancer patients, malnutrition is associated with poorer treatment outcomes and prolonged hospital stays, negatively affecting prognosis and survival. This study aimed to evaluate the internal validity of the nutritional screening tools Nutrition Screening Tool for Childhood Cancer (SCAN) and Screening Tool Risk on Nutritional Status and Growth (STRONGKids) in predicting nutritional risk in hospitalized pediatric cancer patients.
This was a retrospective observational study with pediatric cancer patients hospitalized between February and November 2019. ANPEDCancer was used as a reference to validate SCAN and STRONGKids due to its specificity in nutritional assessment for children and adolescents with cancer. Predictive values and agreement were analyzed. Patients were classified as at nutritional risk or not based on the tools. Nutritional status, anthropometric measures, biochemical markers, and length of stay (LOS) were compared between groups.
Of the 111 patients, 75.7 % (n = 84) were classified as at nutritional risk by SCAN, and 34.2 % (n = 38) as at high risk by STRONGKids. Patients at risk showed greater inadequacy in body composition measures and anthropometric indices. There was an association between nutritional risk as classified by the screening tools and the reduction of lean mass reserves (p = 0.039) and adipose tissue (p = 0.017). C-reactive protein was associated with nutritional risk only in STRONGKids, and with LOS only in SCAN. The agreement was 79.27 % for SCAN and 72.07 % for STRONGKids.
The SCAN demonstrated good precision in the nutritional screening of children with cancer, while STRONGKids was associated with inflamation.
在癌症患者中，营养不良与较差的治疗结果及延长的住院时间相关，对预后和生存产生负面影响。本研究旨在评估儿童癌症营养筛查工具（SCAN）和营养状况与生长风险筛查工具（STRONGKids）在预测住院儿科癌症患者营养风险方面的内部效度。
这是一项回顾性观察研究，研究对象为2019年2月至11月间住院的儿科癌症患者。由于ANPEDCancer在癌症儿童和青少年营养评估方面具有特异性，因此将其用作验证SCAN和STRONGKids的参考标准。分析预测值和一致性。根据这些工具将患者分为有营养风险或无营养风险。比较两组之间的营养状况、人体测量指标、生化标志物和住院时间（LOS）。
在111名患者中，SCAN将75.7%（n = 84）的患者分类为有营养风险，STRONGKids将34.2%（n = 38）的患者分类为高风险。有风险的患者在身体成分测量和人体测量指标方面表现出更大的不足。筛查工具分类的营养风险与瘦体重储备减少（p = 0.039）和脂肪组织减少（p = 0.017）之间存在关联。C反应蛋白仅在STRONGKids中与营养风险相关，仅在SCAN中与住院时间相关。SCAN的一致性为79.27%，STRONGKids的一致性为72.07%。
SCAN在癌症儿童营养筛查中显示出良好的准确性，而STRONGKids与炎症相关。
