STRONGKIDS NUTRITIONAL RISK SCREENING TOOL IS ASSOCIATED WITH INCIDENCE OF HOSPITAL MALNUTRITION
Winra Pratita ,Klara Yuliarti,Aria Kekalih
Department of Child Health University of Sumatera Utara Medical School Department of Child Health University of Indonesia Medical School Department of Community Medicine University of Indonesia Medical School
Background : Prevalence of hospital malnutrition globally is about 20% to 50%. Hospital malnutrition was determined by weight loss during hospitalization. This criteria could not be applied to patients whose weight is not a valid parameter to assess nutritional status (such as cancer, organomegaly, ascites, hydrocephalus). Early detection of hospital malnutrition risk with screening tools is required to prevent hospital malnutrition. Adam Malik Hospital has no policy for nutritional risk screening and no data regarding hospital malnutrition. Primary objective was to determine the prevalence of hospital malnutrition and related factors in Adam Malik Hospital. Secondary objective was to find the correlation of mid-upper circumference (MUAC) decrease compared to weight loss to determine a hospital malnutrition criteria using MUAC.
Material : A prospective cohort study was conducted in Adam Malik Hospital between May to August 2017 on 1-month to 18-year-old hospitalized children with length of stay more than 7 days. STRONGkids, a screening tool for hospital malnutrition risk, was completed in 24 hours since hospital admission. Weight, height, and MUAC were obtained at time of hospital admission and discharge. Weight loss more than 2% during hospitalization was defined as hospital malnutrition. Any decrease of arm circumference was defined as hospital malnutrition for patients whose weight could not be used to determine the nutritional status.
Results : Of 165 participants, prevalence of hospital malnutrition was 40.6%. Subject with moderate and high risk scores had a risk of 8.5 (95% CI: 2.6 to 27.6) and 14.6 times (95% CI: 4.3 to 49.4) of having hospital malnutrition. A 2.5% decrease of MUAC has a 100% sensitivity and 73.5% specificity to define hospital malnutrition.
Conclusions : STRONGkids is strongly associated with hospital malnutrition and could be used as a screening tool for pediatric nutritional care. MUAC can be used to define hospital malnutrition among patients whose weight could not be applied as a valid anthropometric index.
Keywords: STRONGkids Hospital malnutrition Pediatric nutrition care MUAC
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