The majority of paediatric screening tools acknowledge the existing medical conditions as contributing factors to the risk of malnutrition in children but they place different score to different medical conditions which may lead to over or under estimation of nutritional risk. Some tools utilise weight and height measurement as part of their assessment while other tools rely on questions obtained from parents or healthcare professionals, as a result, most screening tools are intended for use by different groups of healthcare professionals. All tools were designed to capture at least one of the following: the current nutritional status of the child, the need for nutritional intervention or to predict the clinical outcome if no intervention is undertaken. Available paediatric screening tools were designed to achieve different objectives hence poor level of agreement between different tools. In paediatrics, there is no consensus on the best nutrition screening tool for hospitalised children. The UK Department of Health recommends that all adult inpatients are nutritionally screened within 24 hours of admission and paediatric inpatients within 48 hours of hospital admission with similar guidelines exist in other countries. Validated nutrition screening tools are associated with improved care and reduced prevalence of nutritional derangement.
Nutrition screenings tools are designed to identify those at risk of malnutrition who may benefit from nutritional interventions. The World Health Organisation has set up guidance to define both acute and chronic malnutrition in children based on z scores of anthropometric measurements. Although it is considered a good practice to screen all hospitalised children upon hospital admission, there is no universally accepted standards for assessment of nutritional status in children.
Nutrition screening to identify at risk hospitalised adults is recommended by the European Society for Clinical Nutrition and Metabolism, the American Society for Parenteral and Enteral Nutrition and the United Kingdom (UK) National Institute for Health and Care Excellence. Suboptimum nutrition can lead to malnutrition which has been associated with increased morbidity, prolonged hospital stay and mortality in critically ill children. Malnutrition remains a common problem in hospitalised children despite the advances in medical interventions.
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