Faculty Collaboration Database

Nutrition Screening in the Pediatric Intensive Care Unit: Evaluation of an Electronic Medical Record-Based Tool. Nutrients 2023 Oct 28;15(21)

Date

11/14/2023

Pubmed ID

37960244

Pubmed Central ID

PMC10647546

DOI

10.3390/nu15214591

Scopus ID

2-s2.0-85176614226 (requires institutional sign-in at Scopus site)

Abstract

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.

Author List

Hilbrands J, Feuling MB, Szabo A, Teng BQ, Fabus N, Froh M, Heisler R, Lampone O, Smith A, Mikhailov TA, Goday PS

Authors

Theresa A. Mikhailov MD, PhD Professor in the Pediatrics department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Bi Qing Teng Biostatistician II in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Critical Illness
Electronic Health Records
Humans
Intensive Care Units, Pediatric
Malnutrition
Nutrition Assessment
Nutritional Status