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Paediatric nutrition risk scores in clinical practice: children with inflammatory bowel disease

Paediatric nutrition risk scores in clinical practice: children with inflammatory bowel disease
Paediatric nutrition risk scores in clinical practice: children with inflammatory bowel disease
BACKGROUND: There has been increasing interest in the use of nutrition risk assessment tools in paediatrics to identify those who need nutrition support. Four non-disease specific screening tools have been developed, although there is a paucity of data on their application in clinical practice and the degree of inter-tool agreement.

METHODS: The concurrent validity of four nutrition screening tools [Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), Screening Tool for Risk On Nutritional status and Growth (STRONGkids), Paediatric Yorkhill Malnutrition Score (PYMS) and Simple Paediatric Nutrition Risk Score (PNRS)] was examined in 46 children with inflammatory bowel disease. Degree of malnutrition was determined by anthropometry alone using World Health Organization International Classification of Diseases (ICD-10) criteria.

RESULTS: There was good agreement between STAMP, STRONGkids and PNRS (kappa > 0.6) but there was only modest agreement between PYMS and the other scores (kappa = 0.3). No children scored low risk with STAMP, STRONGkids or PNRS; however, 23 children scored low risk with PYMS. There was no agreement between the risk tools and the degree of malnutrition based on anthropometric data (kappa < 0.1). Three children had anthropometry consistent with malnutrition and these were all scored high risk. Four children had body mass index SD scores < -2, one of which was scored at low nutrition risk.

CONCLUSIONS: The relevance of nutrition screening tools for children with chronic disease is unclear. In addition, there is the potential to under recognise nutritional impairment (and therefore nutritional risk) in children with inflammatory bowel disease.
inflammatory bowel disease, nutrition risk, nutrition risk screening, paediatrics
0952-3871
319-322
Wiskin, A.E.
2f0070e1-9a80-4856-8c5f-0c91c3d06260
Owens, D.R.
cec8b972-84e9-47a9-9d91-5a225ca7c606
Cornelius, V.R.
5e9e6473-6583-45a0-a1af-ca80f2e879af
Wootton, S.A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Beattie, R. Mark
55d81c7b-08c9-4f42-b6d3-245869badb71
Wiskin, A.E.
2f0070e1-9a80-4856-8c5f-0c91c3d06260
Owens, D.R.
cec8b972-84e9-47a9-9d91-5a225ca7c606
Cornelius, V.R.
5e9e6473-6583-45a0-a1af-ca80f2e879af
Wootton, S.A.
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Beattie, R. Mark
55d81c7b-08c9-4f42-b6d3-245869badb71

Wiskin, A.E., Owens, D.R., Cornelius, V.R., Wootton, S.A. and Beattie, R. Mark (2012) Paediatric nutrition risk scores in clinical practice: children with inflammatory bowel disease. Journal of Human Nutrition and Dietetics, 25 (4), 319-322. (doi:10.1111/j.1365-277X.2012.01254.x). (PMID:22591201)

Record type: Article

Abstract

BACKGROUND: There has been increasing interest in the use of nutrition risk assessment tools in paediatrics to identify those who need nutrition support. Four non-disease specific screening tools have been developed, although there is a paucity of data on their application in clinical practice and the degree of inter-tool agreement.

METHODS: The concurrent validity of four nutrition screening tools [Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), Screening Tool for Risk On Nutritional status and Growth (STRONGkids), Paediatric Yorkhill Malnutrition Score (PYMS) and Simple Paediatric Nutrition Risk Score (PNRS)] was examined in 46 children with inflammatory bowel disease. Degree of malnutrition was determined by anthropometry alone using World Health Organization International Classification of Diseases (ICD-10) criteria.

RESULTS: There was good agreement between STAMP, STRONGkids and PNRS (kappa > 0.6) but there was only modest agreement between PYMS and the other scores (kappa = 0.3). No children scored low risk with STAMP, STRONGkids or PNRS; however, 23 children scored low risk with PYMS. There was no agreement between the risk tools and the degree of malnutrition based on anthropometric data (kappa < 0.1). Three children had anthropometry consistent with malnutrition and these were all scored high risk. Four children had body mass index SD scores < -2, one of which was scored at low nutrition risk.

CONCLUSIONS: The relevance of nutrition screening tools for children with chronic disease is unclear. In addition, there is the potential to under recognise nutritional impairment (and therefore nutritional risk) in children with inflammatory bowel disease.

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e-pub ahead of print date: 16 May 2012
Published date: August 2012
Keywords: inflammatory bowel disease, nutrition risk, nutrition risk screening, paediatrics
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 353508
URI: http://eprints.soton.ac.uk/id/eprint/353508
ISSN: 0952-3871
PURE UUID: 1f0c0dd0-e6cd-4bd7-9b71-c8e06d7ebb39

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Date deposited: 10 Jun 2013 11:28
Last modified: 02 Dec 2019 20:50

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Contributors

Author: A.E. Wiskin
Author: D.R. Owens
Author: V.R. Cornelius
Author: S.A. Wootton
Author: R. Mark Beattie

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