Abstract
Background:
Data on the prevalence of malnutrition in paediatric patients with spinal cord injury (SCI) are limited. The present study aimed to establish the risk of (i) under-nutrition by using the Screening Tool for Assessment of Malnutrition in Paediatrics: STAMP (score ⩾2) and (ii) over-nutrition by body mass index (BMI) centile (⩾91st: overweight; ⩾98th: obese).
Methods:
After obtaining informed consent, a standardized questionnaire was used to collect baseline demographic data and nutrition risk score; BMI was measured and routine blood biochemistry was reviewed in every child (>6 months and <18 years) admitted to the SCI centre.
Results:
Sixty-two children (mean age, 11.4 years; s.d., 4.9; median, 13 years; interquartile range, 7.8–15.6, 39.4% female) with SCI (46.5% tetraplegia, 53.4% complete SCI) were assessed. Prevalence of over-nutrition was high (BMI centile ⩾91st, 41.1%; ⩾98th, 25.5%). Under-nutrition risk was 47.1% (STAMP ⩾2). Only 60% of these ‘at risk’ patients were referred for further nutritional assessment. Associated phenomena included previous intensive care (55.6 versus 20.8%, P<0.05), mechanical ventilation (58.3 versus 18.2%, P<0.01) and past need for artificial nutrition support (75 versus 12.8%, P<0.01).
Conclusions:
Both over- and under-nutrition appear common in children with SCI. Our data indicate, furthermore, that children at nutritional risk are under-managed. Future research is needed to complete the validation of the screening tools and to determine how effective intervention can be ensured.
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Acknowledgements
We thank the patients and ward staff of St Francis ward, Ebba Bergstrom and Kirsten Hart for height estimation, and Pauline Bateman from Medical Records at the National Spinal Injuries Centre at Stoke Mandeville Hospital. We also thank Dr Joan Gandy (The British Dietetic Association) and Professor John Reilly (University of Glasgow) for protocol development.
Author contributions: SW: Protocol development, data collection, data analysis and manuscript preparation. AG: Protocol development, clinical supervision and manuscript revision. SH: Statistical supervision and manuscript revision. GG: Academic supervision and manuscript revision. AF: Academic supervision and manuscript revision.
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This study was funded by unrestricted educational grants from the Waterloo Foundation and Abbott Nutrition (Abbott Laboratories Ltd). The University College London (UCL) staff receive support from the Comprehensive Biomedical Research Centre funding awarded to UCL and its partner Trust by National Institute for Health and Research.
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Wong, S., Graham, A., Harini, S. et al. Profile and prevalence of malnutrition in children with spinal cord injuries—assessment of the Screening Tool for Assessment of Malnutrition in Paediatrics (STAMP). Spinal Cord 50, 67–71 (2012). https://doi.org/10.1038/sc.2011.139
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DOI: https://doi.org/10.1038/sc.2011.139
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