# Modified STRONGkids outperforms PYMS for WHO-defined malnutrition: a screening-to-action pathway for pediatric wards

## TL;DR

This study compares two tools for identifying malnutrition in hospitalized children, finding that the modified STRONGkids tool is more effective than PYMS.

## Contribution

The modified STRONGkids tool is shown to have higher sensitivity and accuracy than PYMS for malnutrition screening in hospitalized children.

## Key findings

- Children with digestive system diseases and those under 1 year of age are at higher risk for malnutrition.
- High-risk children had longer hospital stays, more infections, and lower hemoglobin and prealbumin levels.
- Modified STRONGkids outperformed PYMS in predicting malnutrition in hospitalized children.

## Abstract

The objective of this paper was to understand the nutritional status of hospitalized children and explore the clinical application value of the modified STRONGkids and PYMS screening tools.

Nutritional risk screening was performed using the modified STRONGkids and PYMS tools on 302 children admitted to the pediatric department of our hospital between April 2021 and March 2023. Differences in clinical outcomes and biochemical indicators under different nutritional statuses were analyzed.

Overall, 302 children were included in the current study. The modified STRONGkids screening tool identified 18 (5.96%) children at high risk of malnutrition, 210 (69.54%) at moderate risk, and 74 (24.50%) at low risk. The PYMS screening tool identified 16 (5.30%) children at high risk, 152 (50.33%) at moderate risk, and 134 (44.37%) at low risk. According to WHO nutritional assessment standards, 150 (49.67%) children were identified as borderline malnourished or malnourished. Both the modified STRONGkids and PYMS evaluations indicated that children with digestive system diseases had a significantly higher risk of malnutrition compared with those who had other systemic diseases. Moreover, children under 1 year of age had a significantly higher risk of malnutrition compared with other age groups (P < 0.05). High-risk children identified by both screening methods had higher rates of hospital-acquired infections, longer hospital stays, and lower levels of hemoglobin and prealbumin compared with those at moderate and low risk (P < 0.05). The modified STRONGkids tool demonstrated higher sensitivity and accuracy in predicting malnutrition in hospitalized children compared than the PYMS tool (P < 0.05).

Children with digestive system diseases and those under 1 year of age are at high risk for malnutrition. Both the modified STRONGkids and PYMS tools can effectively identify children at risk of malnutrition, with the modified STRONGkids tool demonstrating better application results.