Malnutrition is often underdiagnosed, and consequently undertreated, in hospitalized patients. A nationwide study is being conducted to validate indicators (the Malnutrition Clinical Characteristics [MCC]) to diagnose malnutrition in hospitalized patients.
For the full study, sixty pediatric hospitals will collect patient medical history, patient STRONGKids malnutrition screening score, and nutrition intervention data. Six hundred pediatric patients will be randomly selected from the cohort to be assessed for the MCC and the Nutrition Focused Physical Exam (NFPE). Medical outcomes will be collected for all patients for a three-month period thereafter. Baseline data from a subset of sites that have started data collection were descriptively analyzed using Stata 15.
As of March 2020, 113 pediatric patients are enrolled in the study, with 50 children ages 1-24 months and 63 children and adolescents ages 2-17. Based on the STRONGkids screener, 73% (n = 82) of participants were “at risk” for malnutrition. A higher proportion of participants in the older age group screened at risk (n=54; 86%) compared to the younger group (n=28; 56%). Fifty-seven of the 113 participants were included in the MCC subgroup, of whom 35 (61%) screened at-risk for malnutrition. Based on the MCC criteria, 49% (n = 28) were diagnosed with malnutrition. Inadequate nutrient intake was the MCC indicator most often used to support a malnutrition diagnosis in younger participants, while weight loss was the most commonly used indicator for older participants. Across both age groups, muscle wasting and subcutaneous fat loss were the most commonly reported NFPE indicators that further supported a malnutrition diagnosis.
Screening-based risk for malnutrition and malnutrition indicators differ for infants and young children compared to older children and teens. Differences in risk factors for malnutrition by age group and the validity of the MCC will be assessed as more data are collected.
Thompson, Samuel; Erin Lamers-Johnson; Kathryn Kelley; Lindsay Woodcock; Julie Long; Courtney Bliss; Jenica K. Abram; Alison Steiber; and Elizabeth Yakes Jimenez. "Screening for and Diagnosing Malnutrition in Hospitalized Pediatric Patients." (2020). https://digitalrepository.unm.edu/hsc_2020_pediatric_research/10