Klanjsek et al reported the Simple Pediatric Nutritional Screen (SPENS) tool to identify a pediatric patient in the hospital with malnutrition. This can be performed quickly without laboratory tests or physical measurements. The authors are from the University of Maribor and University Medical Centre Maribor in Slovenia.
Patient selection: hospitalized patient from age 1 month to 18 years
Parameters:
(1) loss of subcutaneous fat under the eyes based on physical exam
(2) loss of subcutaneous fat over ribs, lower back and sides of trunk on physical exam
(3) refusal or rejection of food
(4) history of poor weight gain over past few months (? also loss)
|
Parameter
|
Finding
|
Beta-Ceofficients
|
|
loss of subcutaneous fat under eyes
|
no
|
0
|
|
|
yes
|
2.5491
|
|
loss of subcutaneous fat on the trunk
|
no
|
0
|
|
|
yes
|
2.3982
|
|
refuse/reject food
|
no
|
0
|
|
|
yes
|
2.4648
|
|
poor weight gain
|
no
|
0
|
|
|
yes
|
1.2805
|
where:
• Loss of subcutaneous fat under the eyes manifests as a hollowed look, depression of the globes and/or dark circles.
• Loss of subcutaneous fat over the turnk manifests as prominence of the ribs and iliac crests.
value of X =
= SUM(points for all of the beta-coefficients) - 3.6347
SPENS =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.98.
• The changes described tend to be seen in severe malnutrition. Mild malnutrition might not be that obvious.
