Comparison of nutritional screening tools in pediatric oncology patients receiving chemotherapy treatment

Abstract

Background

Malnutrition in pediatric oncology patients is a complex and multifactorial process, and the most appropriate screening tool to determine the risk of malnutrition is not clear. The study aimed to compare the Screening Tool for Risk on Nutritional Status and Growth (StrongKids), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), which are commonly used in the general pediatric population, with the Nutrition Screening Tool for Childhood Cancer (SCAN), which was specifically validated for pediatric cancer, in determining the risk of malnutrition.

Methods

This cross-sectional study included 92 children aged 2–18 years who were admitted to the hematology-oncology unit and were receiving chemotherapy. The prevalence of nutritional risk was determined using the SCAN, StrongKids, PYMS, STAMP, and anthropometric assessments were performed. Sensitivity and specificity values, and the degree of agreement between screening tools were calculated.

Result

The SCAN identified nutritional risk in 69.6 % of the children. According to StrongKids, PYMS and STAMP, the high nutritional risk in children was 43.5 %, 56.5 % and 64.1 %, respectively. The sensitivity of STAMP (81.2 %) was higher than that of StrongKids (60.9 %) and PYMS (79.7 %). The specificity of StrongKids, PYMS and STAMP was 96.4 %, 96.4 %, and 75.0 %, respectively. There was substantial agreement between SCAN and PYMS.

Conclusion

PYMS has the best specificity and sensitivity in identifying patients at risk of malnutrition as determined by SCAN.

Implications for practice

In addition to anthropometric measurements, population-specific or highly sensitive nutritional screening tools should be used to determine the risk of malnutrition.