Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children

Clin Nutr. 2010 Feb;29(1):106-11. doi: 10.1016/j.clnu.2009.07.006. Epub 2009 Aug 13.


Background & aims: Children admitted to the hospital are at risk of developing malnutrition. The aim of the present study was to investigate the feasibility and value of a new nutritional risk screening tool, called STRONG(kids), in a nationwide study.

Methods: A Prospective observational multi-centre study was performed in 44 Dutch hospitals (7 academic and 37 general), over three consecutive days during the month of November 2007. The STRONG(kids) screening tool consisted of 4 items: (1) subjective clinical assessment, (2) high risk disease, (3) nutritional intake, (4) weight loss. Measurements of weight and length were performed. SD-scores <-2 for weight-for-height and height-for-age were considered to indicate acute and chronic malnutrition respectively.

Results: A total of 424 children were included. Median age was 3.5 years and median hospital stay was 2 days. Sixty-two percent of the children were classified "at risk" of developing malnutrition by the STRONG(kids) tool. Children at risk had significantly lower SD-scores for weight-for-height, a higher prevalence of acute malnutrition and a longer hospital stay compared to children with no nutritional risk.

Conclusions: The nutritional risk screening tool STRONG(kids) was successfully applied to 98% of the children. Using this tool, a significant relationship was found between having a "high risk" score, a negative SD-score in weight-for-height and a prolonged hospital stay.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Height
  • Body Weight
  • Child
  • Child Nutrition Disorders / diagnosis*
  • Child Nutrition Disorders / epidemiology
  • Child Nutritional Physiological Phenomena*
  • Child, Hospitalized / statistics & numerical data*
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Length of Stay / statistics & numerical data
  • Male
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data*
  • Netherlands / epidemiology
  • Nutrition Surveys*
  • Nutritional Status
  • Prevalence
  • Prospective Studies
  • Reproducibility of Results
  • Risk Factors
  • Surveys and Questionnaires