Nutritional risk screening and its clinical significance in hospitalized children

Background & aims: To analyse nutritional risk in hospitalized children and its relationship with clinical outcomes to provide evidence for improved nutritional management. Methods: The investigation involved 1325 consecutively enrolled hospitalized children from Nanjing Children's Hospital. The nutritional risks in the hospitalized children were evaluated using the STRONGkids tool. During hospitalization, the incidence of infectious complications, length of hospital stay, weight loss, hospital expenses and nutritional support were recorded. Results: The percentages of children with high, moderate and low nutritional risk were 9.1% (121), 43.3% (574) and 47.6% (630), respectively. Children with cardiac, respiratory or oncologic disease were most likely to have high nutritional risk. STRONGkids scores were correlated with clinical outcome. Higher complication rates, longer stay lengths, greater weight loss and greater hospital expenses were observed in children with high nutritional risk compared to those with moderate or low risk (p < 0.001). Nutritional support during hospitalization was given to 62.8% (76) of children with high nutritional risk, 18.6% (107) of children with moderate nutritional risk and 8.9% (56) of children with low nutritional risk. Conclusions: Hospitalized children exposed to high or moderate nutritional risks have poor clinical outcomes. Nutritional support is not yet performed appropriately. Evidence-based guidelines should be created to improve this situation. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.