Simple pediatric nutritional risk score to identify children at risk of malnutrition

Background: Although hospitalized children are at risk of malnutrition, rou tine screening of nutritional status has been hindered by lack of a validat ed nutritional assessment tool. Objective: Our aim was to develop a simple pediatric nutritional risk score that could be used at hospital admission to identify patients at risk of a cute malnutrition during hospitalization. Design: Nutritional risk was assessed prospectively in 296 children. Anthro pometric measurements, food intake, ability to eat and retain food, medical condition, and symptoms interfering with feeding (pain, dyspnea, and depre ssion) were evaluated within 48 h of admission. Pathology was classified as mild (grade 1), moderate (grade 2), or severe (grade 3). The risk of weigh t loss was investigated with stepwise logistic regression. Results: Weight loss during hospitalization occurred in 65% of the children and was >2% of admission weight in 45% of patients. Multivariate analysis indicated that food intake <50%, pain, and grade 2 and 3 pathologic conditi ons (P = 0.0001 for all) were associated with weight losses of >2%. The nut ritional risk score ranged from 0 to 5 and was calculated by adding the val ues for the significant risk factors as follows: 1 for food intake <50%. I for pain, 1 for grade 2 pathologic condition, and 3 for grade 3 pathologic condition. A score of 1 or 2 indicated moderate risk and a score greater th an or equal to 3 indicated high risk of malnutrition. Conclusions: This simple score is suitable for routine use to identify pati ents at risk of malnutrition during hospitalization. Implementation may pre vent hospital-acquired malnutrition.