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.
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.