title: Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting.
abstract: BACKGROUND
  An increased but unpredictable risk of malnutrition is associated with hospitalization, especially in children with chronic diseases. We investigated the applicability of Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids), an instrument proposed to estimate the risk of malnutrition in hospitalized children. We also evaluated the role of age and co-morbidities as risk for malnutrition.
  
  
  METHODS
  The STRONGkids consists of 4 items providing a score that classifies a patient in low, moderate, high risk for malnutrition. A prospective observational multi-centre study was performed in 12 Italian hospitals. Children 1-18 years consecutively admitted and otherwise unselected were enrolled. Their STRONGkids score was obtained and compared with the actual nutritional status expressed as BMI and Height for Age SD-score.
  
  
  RESULTS
  Of 144 children (75 males, mean age 6.5 ± 4.5 years), 52 (36%) had an underlying chronic disease. According to STRONGkids, 46 (32%) children were at low risk, 76 (53%) at moderate risk and 22 (15%) at high risk for malnutrition. The latter had significantly lower Height for Age values (mean SD value -1.07 ± 2.08; p = 0.008) and BMI values (mean SD-values -0.79 ± 2.09; p = 0.0021) in comparison to other groups. However, only 29 children were actually malnourished.
  
  
  CONCLUSIONS
  The STRONGkids is easy to administer. It is highly sensitive but not specific. It may be used as a very preliminary screening tool to be integrated with other clinical data in order to reliably predict the risk of malnutrition.
authors.forename: Maria Immacolata
authors.initials: MI
authors.lastname: Spagnuolo
authors.forename: Ilaria
authors.initials: I
authors.lastname: Liguoro
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Chiatto
authors.forename: Daniela
authors.initials: D
authors.lastname: Mambretti
authors.affiliation: Department of Translational Medical Science - Section of Pediatrics, University of Naples "Federico II", Naples, Italy. alfguari@unina.it.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarino
mesh_terms: D000367:Age Factors; D000886:Anthropometry; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015596:Nutrition Assessment; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors