Performance of the new nutrition evaluation tool for hospitalized pediatric patients with cancer in Brazil (ANPEDCancer)

Abstract

Background There is a lack of specific nutrition assessment tools for pediatric patients with cancer. The aim was to evaluate the performance of the ANPEDCancer assessment tool in a pediatric population with cancer, verifying its ability to detect nutrition inadequacy and predict the length of hospital stay (LOS). Methods Evaluated 111 pediatric patients hospitalized in the National Cancer Institute (INCA) in 2019 to assess nutrition status. Patients were classified as malnourished and well nourished by the ANPEDCancer. Measures of weight, height, anthropometric indicators, body composition, laboratory parameters, LOS, and death were compared between groups. The ANPEDCancer classification was compared with the complete nutrition assessment, calculating sensitivity, specificity, and predictive values, and with the LOS. Results The prevalence of malnutrition was 12.6%, nutrition risk was 48.6%, risk of overweight/obesity was 6.3%, and well‐nourished status was 32.4%. According to ANPEDCancer, malnourished patients showed a higher frequency of inadequacy for all anthropometric indices, percentage of weight loss, serum albumin level, C‐reactive protein (CRP), and longer LOS when compared with well‐nourished patients. There was an association between the tool's diagnosis and measures of body composition, CRP, and LOS. ANPEDCancer validation with the complete nutrition assessment showed a sensitivity of 81.6%, specificity of 55%, positive predictive value of 53.4%, and negative of 82.5%. The LOS was almost twice as long among malnourished patients and was statistically significant (P = 0.002). Conclusion ANPEDCancer is a feasible tool to assess nutrition status and identify the presence of nutrition risk, allowing for targeted assistance in hospitalized pediatric patients with cancer.

Mid‐upper arm circumference in hospitalized pediatric patients with cancer: Is there an association with malnutrition?

“…In addition, MUAC showed a strong association with BMI/A, consistent with the findings of Barr et al 12 In addition, the incorporation of MUAC in a specific nutrition assessment instrument for children and adolescents with cancer was mandatory for nutritionists in the construction of the Nutritional Assessment Tool for Pediatric Cancer Patients (ANPEDCancer tool) and was associated with physical examination data (fat and muscle mass) in the validation study. 18,19 Therefore, MUAC can be considered a good parameter for assessing nutrition status as its measurement is independent of tumor mass, quick to implement, and inexpensive.…”

“…This was an observational, cross-sectional study with hospitalized children and adolescents with cancer. Data were generated from February to November 2019 during the "Construction and validation of a nutritional assessment instrument for hospitalized pediatric patients with cancer" 18,19 study and were used to address the objectives of this study.…”