ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1572805
This article is part of the Research TopicClinical Nutrition in Newborns and Children with DisabilitiesView all 3 articles
Efficiency Analysis of Nutritional Screening Tools for Children with Congenital Heart Disease：A Retrospective Observational Study
Provisionally accepted
- 1Department of Clinical Nutrition, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- 2Fujian Center for Prevention and Control of Occupational Diseases and Chemical Poisoning, Fuzhou, Fujian Province, China
- 3Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- 4Department of Food and Nutritional Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Objective:This study aimed to (1) determine the prevalence of malnutrition among hospitalized children with congenital heart disease (CHD); (2) evaluate the effectiveness of common pediatric nutritional screening tools across age groups; and (3) assess their ability to identify severe malnutrition to guide early intervention.Methods:A retrospective analysis was conducted on 3,677 CHD patients aged 0–18 years who underwent surgery at the Cardiothoracic Surgery Center between January 2018 and December 2022. The World Health Organization (WHO) growth curves were used as the diagnostic standard. Four screening tools were evaluated: STAMP, STRONGkids, RACHS-1, and a combined score (SS = [STAMP + STRONGkids]/2). Categorical variables were analyzed using chi-square tests and Bonferroni correction. ROC curves, Youden’s index, and Kappa values were used to assess diagnostic performance.Results:The overall malnutrition prevalence was 32.9%. The SS tool achieved the highest AUC (0.863), followed by STAMP (0.841) and STRONGkids (0.747) (P < 0.01). RACHS-1 performed poorly (AUC 0.525, P > 0.01). Optimal Youden indices were observed at cutoff values of 3.5 (STAMP), 2.5 (STRONGkids), and 3.25 (SS). Age-specific analysis showed STAMP and SS were most sensitive in the 6–18-year group, while STRONGkids performed best in the 0–1-year group. STAMP (2.5) and SS (2.75) provided balanced sensitivity and specificity across all age groups. For severe malnutrition, STAMP at 3.5 and SS at 3.25 offered the best performance (P < 0.001).Conclusion:Among hospitalized CHD patients, STAMP outperforms STRONGkids, and the SS score offers superior overall screening accuracy. RACHS-1 is not recommended for nutritional risk assessment. Age- and severity-specific cutoff adjustments enhance clinical utility.
Keywords: congenital heart disease, Nutritional screening, Malnutrition, Stamp, STRONGkids
Received: 07 Feb 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Xu, Jiang, Guo, Wang, Huang, Xie and Liao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dongshan Liao, Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
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