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Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool

Hospitalized, critically ill children are at increased risk of developing malnutrition. While several pediatric nutrition screening tools exist, none have been validated in the pediatric intensive care units (PICU). The Children’s Wisconsin Nutrition Screening Tool (CWNST) is a unique nutrition scre...

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Autores principales: Hilbrands, Julia, Feuling, Mary Beth, Szabo, Aniko, Teng, Bi Q., Fabus, Nicole, Froh, Melissa, Heisler, Rebecca, Lampone, Olivia, Smith, Amber, Mikhailov, Theresa A., Goday, Praveen S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647546/
https://www.ncbi.nlm.nih.gov/pubmed/37960244
http://dx.doi.org/10.3390/nu15214591
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author Hilbrands, Julia
Feuling, Mary Beth
Szabo, Aniko
Teng, Bi Q.
Fabus, Nicole
Froh, Melissa
Heisler, Rebecca
Lampone, Olivia
Smith, Amber
Mikhailov, Theresa A.
Goday, Praveen S.
author_facet Hilbrands, Julia
Feuling, Mary Beth
Szabo, Aniko
Teng, Bi Q.
Fabus, Nicole
Froh, Melissa
Heisler, Rebecca
Lampone, Olivia
Smith, Amber
Mikhailov, Theresa A.
Goday, Praveen S.
author_sort Hilbrands, Julia
collection PubMed
description Hospitalized, critically ill children are at increased risk of developing malnutrition. While several pediatric nutrition screening tools exist, none have been validated in the pediatric intensive care units (PICU). The Children’s Wisconsin Nutrition Screening Tool (CWNST) is a unique nutrition screening tool that includes the Pediatric Nutrition Screening Tool (PNST) and predictive elements from the electronic medical record and was found to be more sensitive than the PNST in acute care units. The aim of this study was to assess the performance of the tool in detecting possible malnutrition in critically ill children. The data analysis, including the results of the current nutrition screening, diagnosis, and nutrition status was performed on all patients admitted to PICUs at Children’s Wisconsin in 2019. All 250 patients with ≥1 nutrition assessment by a dietitian were included. The screening elements that were predictive of malnutrition included parenteral nutrition, positive PNST, and BMI-for-age/weight-for-length z-score. The current screen had a sensitivity of 0.985, specificity of 0.06, positive predictive value (PPV) of 0.249, and negative predictive value of 0.929 compared to the PNST alone which had a sensitivity of 0.1, specificity of 0.981, PPV of 0.658, and NPV of 0.749. However, of the 250 included patients, 97.2% (243) had a positive nutrition screen. The CWNST can be easily applied through EMRs and predicts the nutrition risk in PICU patients but needs further improvement to improve specificity.
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spelling pubmed-106475462023-10-28 Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool Hilbrands, Julia Feuling, Mary Beth Szabo, Aniko Teng, Bi Q. Fabus, Nicole Froh, Melissa Heisler, Rebecca Lampone, Olivia Smith, Amber Mikhailov, Theresa A. Goday, Praveen S. Nutrients Article Hospitalized, critically ill children are at increased risk of developing malnutrition. While several pediatric nutrition screening tools exist, none have been validated in the pediatric intensive care units (PICU). The Children’s Wisconsin Nutrition Screening Tool (CWNST) is a unique nutrition screening tool that includes the Pediatric Nutrition Screening Tool (PNST) and predictive elements from the electronic medical record and was found to be more sensitive than the PNST in acute care units. The aim of this study was to assess the performance of the tool in detecting possible malnutrition in critically ill children. The data analysis, including the results of the current nutrition screening, diagnosis, and nutrition status was performed on all patients admitted to PICUs at Children’s Wisconsin in 2019. All 250 patients with ≥1 nutrition assessment by a dietitian were included. The screening elements that were predictive of malnutrition included parenteral nutrition, positive PNST, and BMI-for-age/weight-for-length z-score. The current screen had a sensitivity of 0.985, specificity of 0.06, positive predictive value (PPV) of 0.249, and negative predictive value of 0.929 compared to the PNST alone which had a sensitivity of 0.1, specificity of 0.981, PPV of 0.658, and NPV of 0.749. However, of the 250 included patients, 97.2% (243) had a positive nutrition screen. The CWNST can be easily applied through EMRs and predicts the nutrition risk in PICU patients but needs further improvement to improve specificity. MDPI 2023-10-28 /pmc/articles/PMC10647546/ /pubmed/37960244 http://dx.doi.org/10.3390/nu15214591 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hilbrands, Julia
Feuling, Mary Beth
Szabo, Aniko
Teng, Bi Q.
Fabus, Nicole
Froh, Melissa
Heisler, Rebecca
Lampone, Olivia
Smith, Amber
Mikhailov, Theresa A.
Goday, Praveen S.
Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool
title Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool
title_full Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool
title_fullStr Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool
title_full_unstemmed Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool
title_short Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool
title_sort nutrition screening in the pediatric intensive care unit: evaluation of an electronic medical record-based tool
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647546/
https://www.ncbi.nlm.nih.gov/pubmed/37960244
http://dx.doi.org/10.3390/nu15214591
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