Nutrition screening in hospitalized children in Malta

Abstract

Optimal nutrition is essential for children's growth, yet hospitalized children are at higher risk of malnutrition. This study aimed to assess the need for a nutrition screening tool (NST) for hospitalized children in Malta. This was carried out by evaluating malnutrition prevalence using anthropometry, and assessing malnutrition risk using the Subjective Global Nutrition Assessment (SGNA), the Paediatric Yorkhill Malnutrition Score (PYMS), and the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). The hospital length of stay (LOS) and dietitian referrals were assessed, and the best NST to be used locally was recommended. Data was collected over a 6-week period in the paediatric wards of Malta’s acute general hospital. Results revealed a double burden of malnutrition with 12% with acute/chronic malnutrition and 17.2% who were overweight/obese. Malnutrition risk was identified as 33% (SGNA), 55% (PYMS), and 79% (STAMP), respectively, with higher risk linked to longer hospital stays. Despite significant malnutrition risk, dietitian referrals were low, at 11.8% (PYMS) and 6.3% (STAMP). PYMS showed higher specificity, positive predictive value (PPV), and likelihood ratio, while STAMP had higher sensitivity, negative predictive value (NPV) and false positive rate. The study concluded that an NST is needed locally, recommending PYMS as the better NST to be used in this setting. This aligned with the 2022 Global Nutrition Report's call for integrated nutrition care in healthcare systems to achieve the 2025 Global Nutrition Targets for stunting, wasting and overweight children. Future research should focus on establishing a universally accepted gold standard, validating PYMS for younger children, and expanding the study to different hospitals, and across different seasons for comprehensive data on malnutrition risk.