title: Profile and prevalence of malnutrition in children with spinal cord injuries-assessment of the Screening Tool for Assessment of Malnutrition in Paediatrics (STAMP).
abstract: BACKGROUND
  Data on the prevalence of malnutrition in paediatric patients with spinal cord injury (SCI) are limited. The present study aimed to establish the risk of (i) under-nutrition by using the Screening Tool for Assessment of Malnutrition in Paediatrics: STAMP (score ≥2) and (ii) over-nutrition by body mass index (BMI) centile (≥91st: overweight; ≥98th: obese).
  
  
  METHODS
  After obtaining informed consent, a standardized questionnaire was used to collect baseline demographic data and nutrition risk score; BMI was measured and routine blood biochemistry was reviewed in every child (>6 months and <18 years) admitted to the SCI centre.
  
  
  RESULTS
  Sixty-two children (mean age, 11.4 years; s.d., 4.9; median, 13 years; interquartile range, 7.8-15.6, 39.4% female) with SCI (46.5% tetraplegia, 53.4% complete SCI) were assessed. Prevalence of over-nutrition was high (BMI centile ≥91st, 41.1%; ≥98th, 25.5%). Under-nutrition risk was 47.1% (STAMP ≥2). Only 60% of these 'at risk' patients were referred for further nutritional assessment. Associated phenomena included previous intensive care (55.6 versus 20.8%, P<0.05), mechanical ventilation (58.3 versus 18.2%, P<0.01) and past need for artificial nutrition support (75 versus 12.8%, P<0.01).
  
  
  CONCLUSIONS
  Both over- and under-nutrition appear common in children with SCI. Our data indicate, furthermore, that children at nutritional risk are under-managed. Future research is needed to complete the validation of the screening tools and to determine how effective intervention can be ensured.
authors.affiliation: National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK. Samford.Wong@ucl.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Wong
authors.forename: A
authors.initials: A
authors.lastname: Graham
authors.forename: S P
authors.initials: SP
authors.lastname: Harini
authors.forename: G
authors.initials: G
authors.lastname: Grimble
authors.forename: A
authors.initials: A
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology* / Q000503:physiopathology; D002675:Child, Preschool; D015897:Comorbidity / Q000639:trends; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires / Q000592:standards