• Jessie M Hulst, Henrike Zwart, Wim C Hop, and Koen F M Joosten.
• Erasmus MC, Department of Pediatrics, Sophia's Children Hospital, Rotterdam, The Netherlands. j.hulst@erasmusmc.nl
• Clin Nutr. 2010 Feb 1; 29 (1): 106-11.

Background & AimsChildren admitted to the hospital are at risk of developing malnutrition. The aim of the present study was to investigate the feasibility and value of a new nutritional risk screening tool, called STRONG(kids), in a nationwide study.MethodsA Prospective observational multi-centre study was performed in 44 Dutch hospitals (7 academic and 37 general), over three consecutive days during the month of November 2007. The STRONG(kids) screening tool consisted of 4 items: (1) subjective clinical assessment, (2) high risk disease, (3) nutritional intake, (4) weight loss. Measurements of weight and length were performed. SD-scores <-2 for weight-for-height and height-for-age were considered to indicate acute and chronic malnutrition respectively.ResultsA total of 424 children were included. Median age was 3.5 years and median hospital stay was 2 days. Sixty-two percent of the children were classified "at risk" of developing malnutrition by the STRONG(kids) tool. Children at risk had significantly lower SD-scores for weight-for-height, a higher prevalence of acute malnutrition and a longer hospital stay compared to children with no nutritional risk.ConclusionsThe nutritional risk screening tool STRONG(kids) was successfully applied to 98% of the children. Using this tool, a significant relationship was found between having a "high risk" score, a negative SD-score in weight-for-height and a prolonged hospital stay.Copyright 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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