Factors influencing malnutrition risk in hospitalized pediatric patients and the application of STRONGkids scoring

Aim: A significant factor affecting the response to treatment in children is malnutrition. To reduce its risk and morbidity, necessary precautions should be taken on the first day of hospitalization. It is highly essential to obtain clues that assist with the early detection of malnutrition at the time of hospitalization. In this study, we aimed to show the risk factors, body measurements and the importance of a scoring system in its early detection and evaluation. To this end, we examined the accuracy of the STRONGkids score, which is a simple, useful, and practical scoring system, in detecting the risk of malnutrition. Methods: Children between 0-18 years of age without any chronic diseases who were hospitalized due to acute infection were included in this retrospective cohort study. Those with chronic illnesses were left out of scope of our research. The duration and frequency of hospitalization, maternal age, number of births, birth weight, duration of breastfeeding and its continuation, transition period of supplemental nutrition intake, respective weights measured at the time of hospitalization and discharge were evaluated. By using Gomez and Waterlow, malnutrition degree and STRONGkids score were calculated and the risk of malnutrition was determined. Results: Among all, 61% of the children included in the study were males. While the mean age was 34.67 (39.95) months, 84.62% of the children’s age was less than or equal to 60 months and 15.38% were aged over 60 months. Based on the STRONGkids scores, 55.77%, 31.41% and 12.82% of the included cases were low, moderate, and high-risk in terms of malnutrition, respectively. The length of hospitalization, breastfeeding duration and maternal age were related with middle arm circumference. Conclusion: Malnutrition risk should be evaluated together with various risk factors rather than one. The definition and classification of malnutrition vary based on the method used. Middle arm circumference can be used together with STRONGKIDS score in estimating the duration of hospitalization and the level of malnutrition.