In addition to the risk score described in the previous section, Sermet-Gaudelus developed a logistic regression formula to identify a hospitalized child at risk for malnutrition. This can allow for early intervention prior to the development of complications. The authors are from Hopital Necker-Enfants Malades in Paris.
Parameters:
(1) food intake
(2) pain
(3) grade of pathologic condition
Grade 1 (Mild) Conditions |
Grade 2 (Moderate) Conditions |
Grade 3 (Severe) Conditions |
---|---|---|
admission for diagnostic procedure |
severe infections but not life-threatening |
AIDS |
minor infection |
routine surgery |
malignancy |
mild episodic illness |
fractures |
severe sepsis |
minor surgery |
chronic illness without acute deterioration |
major surgery (cardiac surgery, major abdominal) |
gastroenteritis |
inflammatory bowel disease |
multiple injuries |
|
cystic fibrosis |
acute deterioration of a chronic disease |
|
sickle cell disease |
major depression |
from Table 1 page 66 and text page 65
Parameter |
Finding |
Points |
---|---|---|
food intake |
>= 50% of dietary allowance |
0 |
|
< 50% of dietary allowance |
1 |
pain |
child <= 6 years with no sign of pain |
0 |
|
child <= 6 years with any visible sign of pain |
1 |
|
child > 6 years with visual analogue pain score <= 40 out of 100 |
0 |
|
child > 6 years with visual analogue pain score > 40 out of 100 |
1 |
grade 2 condition |
absent |
0 |
|
present |
1 |
grade 3 condition |
absent |
0 |
|
present |
1 |
where:
• Signs of pain in a small child may include incessant crying or abnormal movements.
• The visual analogue scale (VAS) for pain ranged from 0 for no pain to 100 for worst pain imaginable.
• Although not specifically mentioned in the paper, I assume that a grade 2 condition is not scored if a grade 3 condition is present.
F =
= (0.9594 * (points for food intake)) + (0.7789 * (points for pain)) + (1.004 * (points for grade 2 condition)) + (3.214 * (points for grade 3 condition)) - 2.498
probability of a > 2% weight loss =
= 1 / (1 + EXP((-1) * F))
Purpose: To identify a hospitalizaed child at risk for malnutrition using the logistic regression formula of Sermet-Gaudelus et al.
Specialty: Nutrition, Pedatrics
Objective: clinical diagnosis, including family history for genetics
ICD-10: E43, E44,