Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-14T20:04:37.090Z Has data issue: false hasContentIssue false

Validation of the Screening Tool for the Assessment of Malnutrition (STAMP) in patients with Spinal Cord Injuries (SCI)

Published online by Cambridge University Press:  27 January 2012

S. S. Wong
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK Centre for Gastroenterology and Clinical Nutrition, University College London, UK
A. Graham
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK
G. Grimble
Affiliation:
Centre for Gastroenterology and Clinical Nutrition, University College London, UK
A. Forbes
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK
Rights & Permissions [Opens in a new window]

Abstract

Type
Abstract
Copyright
Copyright © The Authors 2012

The prevalence of childhood malnutrition lies between 15 and 30% in hospital practice(Reference McCarthy1, Reference Gerasimidis2), it may be higher still in neuro-disabilities patients such as those with spinal cord injuries (SCI). A number of paediatric nutrition screening tools (PNST) has been developed(Reference McCarthy1, Reference Gerasimidis2) but their use in the SCI population requires further investigation. The aims of the present study was to validate the Screening Tool for the Assessment of Malnutrition (STAMP)(Reference McCarthy1) in paediatric patients with SCI. On admission, children were screened by this tool by the nursing staff. Its validity was assessed by (i) comparison with dietetic assessment (criterion validity); (ii) comparison with another generic PNST: the Paediatric Yorkhill Malnutrition Score(Reference Gerasimidis2) (PYMS) (concurrent validity); and (iii) completion of an additional STAMP screening was completed by the research dietitian to assess inter- and intra-rater reliability. The levels of agreement were assessed using Cohen's Κ-statistics(Reference Landis and Koch3). Fifty-one children were screened. The prevalence of undernutrition risk was 42.1%. STAMP had moderate agreement with dietitian assessment (Κ: 0.578, 95% CI:0.304–0.851) and fair agreement with PYMS (Κ: 0.314, 95% CI:0.08–0.552). The STAMP had substantial reliability (inter-rater reliability: k: 0.752, 95%CI: 0.568–0.935; intra-rater reliability: Κ: 0.635, 95% CI: 0.392–0.878). When compared with dietetic assessment, STAMP was numerically (but not significantly) less sensitive (70.6% v 76.4%), and less specific *87.5% v 93.7%), and it had weaker agreement than PYMS (Κ: 0.58 v 0.69). Although it is possible that the diagnostic accuracy is lower than that of other generic PNSTs, STAMP is probably still an acceptable tool for the identification of SCI children at risk of undernutrition. Further investigation is warranted to test its predictive validity.

The authors would like the Waterloo Foundation and Abbott Nutrition for the financial support. UCL Staff receive support from the CBRC funding awarded to UCL and its partner Trust by NIHR.

References

1.McCarthy, et al. . 2008: J Hum Nutr Diet 21, 395396.CrossRefGoogle Scholar
2.Gerasimidis, K et al. . 2010: Br J Nutr 104, 751756CrossRefGoogle Scholar
3.Landis, JR & Koch, GG (1977) Biometrics 33, 159174.CrossRefGoogle Scholar