Predictive value of STAMP in Health Information System in children with critical congenital heart disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Li ¹ , FENG Mei ¹ , ZHOU Dan ¹ ,  SONG Jinping ² ,  TANG Menglin ¹

1. West China School of Nursing, Sichuan University/Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. West China School of Nursing, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

SONG Jinping, Email: jinpings210@163.com; TANG Menglin, Email: menglintang@163.com

Keywords：

Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP); congenital heart disease; intensive care; children; nutritional risk screening; predictive value

DOI：

10.7507/1007-4848.202104090

Video：

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Objective To analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD).Methods A total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected.Results (1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively.Conclusion Children with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.

Citation： LI Li, FENG Mei, ZHOU Dan, SONG Jinping, TANG Menglin. Predictive value of STAMP in Health Information System in children with critical congenital heart disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(11): 1340-1345. doi: 10.7507/1007-4848.202104090 Copy

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2.	徐京, 李梅, 莫绪明, 等. 口腔运动干预在复杂型先天性心脏病患儿术后喂养技能改善中的实践与效果评价. 护士进修杂志, 2020, 35(19): 1773-1777.
3.	Batte A, Lwabi P, Lubega S, et al. Wasting, underweight and stunting among children with congenital heart disease presenting at Mulago hospital, Uganda. BMC Pediatr, 2017, 17(1): 10.
4.	吴莉娟, 李中跃. 儿科营养风险筛查工具应用进展. 中国实用儿科杂志, 2020, 35(7): 567-570.
5.	Dos Santos CA, Ribeiro AQ, Rosa COB, et al. Nutritional risk in pediatrics by StrongKids: A systematic review. Eur J Clin Nutr, 2019, 73(11): 1441-1449.
6.	McCarthy H, Dixon M, Crabtree I, et al. The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP©) for use by healthcare staff. J Hum Nutr Diet, 2012, 25(4): 311-318.
7.	Reed M, Mullaney K, Ruhmann C, et al. Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in the electronic health record: A validation study. Nutr Clin Pract, 2020, 35(6): 1087-1093.
8.	刘正伟, 徐信兰, 曾玉结, 等. 比较两种营养风险筛查工具在先心病病儿中的诊断效能研究. 肠外与肠内营养, 2021, 28(1): 30-34.
9.	Bouma S. Diagnosing pediatric malnutrition: Paradigm shifts of etiology-related definitions and appraisal of the indicators. Nutr Clin Pract, 2017, 32(1): 52-67.
10.	杨玉霞, 顾莺, 叶岚, 等. 2 种营养筛查工具在先天性心脏病患儿中的应用比较. 护士进修杂志, 2019, 34(21): 1925-1928.
11.	杨玉霞, 顾莺, 叶岚, 等. 基于喂养过程和喂养结局评价的先天性心脏病患儿喂养困难现状研究. 护士进修杂志, 2020, 35(15): 1436-1439.
12.	Leitch CA. Growth, nutrition and energy expenditure in pediatric heart failure. Prog Pediatr Cardiol, 2000, 11(3): 195-202.
13.	Zhang J, Cui YQ, Ma ZM, et al. Energy and protein requirements in children undergoing cardiopulmonary bypass surgery: Current problems and future direction. JPEN J Parenter Enteral Nutr, 2019, 43(1): 54-62.
14.	Zhang M, Wang L, Huang R, et al. Risk factors of malnutrition in Chinese children with congenital heart defect. BMC Pediatr, 2020, 20(1): 213.
15.	戚继荣, 莫绪明, 李荣, 等. 儿童营养风险及发育不良筛查工具用于先天性心脏病患儿围术期营养风险筛查. 中华临床营养杂志, 2014, 22(1): 38-42.
16.	中华医学会小儿外科学分会心胸外科学组, 中华医学会肠外肠内营养学分会儿科学组. 先天性心脏病患儿营养支持专家共识. 中华小儿外科杂志, 2016, 37(1): 3-8.
17.	陈阳, 刘瑞萍, 武海滨. PICU 患儿营养风险筛查及高风险对临床结局的影响. 中国妇幼健康研究, 2020, 31(11): 1537-1540.
18.	冯升, 成磊, 陆华, 等. 两种营养风险筛查工具用于危重患儿诊断效能研究. 护理学杂志, 2018, 33(11): 15-19.
19.	张慧文, 顾莺, 杨玉霞, 等. STAMP 量表筛检住院儿童营养不良风险的系统评价. 护理学杂志, 2016, 31(7): 85-90.
20.	冯升, 成磊, 陆华, 等. 儿科营养不良评估筛查工具用于住院患儿营养风险筛查的诊断效能研究. 护理管理杂志, 2019, 19(4): 233-236.
21.	冯蓓, 梁亚红, 贺婷婷, 等. 2 种营养不良风险筛查工具对儿科住院患儿营养不良风险预测作用的比较. 护理学报, 2020, 27(10): 65-68.
22.	武勰, 刁晓林, 罗启鹏, 等. 围术期白细胞计数对小儿简单先天性心脏病术后严重并发症的预测价值. 中国循环杂志, 2018, 33(S1): 62.

1. Saliba A, Figueiredo ACV, Baroneza JE, et al. Genetic and genomics in congenital heart disease: A clinical review. J Pediatr (Rio J), 2020, 96(3): 279-288.
2. 徐京, 李梅, 莫绪明, 等. 口腔运动干预在复杂型先天性心脏病患儿术后喂养技能改善中的实践与效果评价. 护士进修杂志, 2020, 35(19): 1773-1777.
3. Batte A, Lwabi P, Lubega S, et al. Wasting, underweight and stunting among children with congenital heart disease presenting at Mulago hospital, Uganda. BMC Pediatr, 2017, 17(1): 10.
4. 吴莉娟, 李中跃. 儿科营养风险筛查工具应用进展. 中国实用儿科杂志, 2020, 35(7): 567-570.
5. Dos Santos CA, Ribeiro AQ, Rosa COB, et al. Nutritional risk in pediatrics by StrongKids: A systematic review. Eur J Clin Nutr, 2019, 73(11): 1441-1449.
6. McCarthy H, Dixon M, Crabtree I, et al. The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP©) for use by healthcare staff. J Hum Nutr Diet, 2012, 25(4): 311-318.
7. Reed M, Mullaney K, Ruhmann C, et al. Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in the electronic health record: A validation study. Nutr Clin Pract, 2020, 35(6): 1087-1093.
8. 刘正伟, 徐信兰, 曾玉结, 等. 比较两种营养风险筛查工具在先心病病儿中的诊断效能研究. 肠外与肠内营养, 2021, 28(1): 30-34.
9. Bouma S. Diagnosing pediatric malnutrition: Paradigm shifts of etiology-related definitions and appraisal of the indicators. Nutr Clin Pract, 2017, 32(1): 52-67.
10. 杨玉霞, 顾莺, 叶岚, 等. 2 种营养筛查工具在先天性心脏病患儿中的应用比较. 护士进修杂志, 2019, 34(21): 1925-1928.
11. 杨玉霞, 顾莺, 叶岚, 等. 基于喂养过程和喂养结局评价的先天性心脏病患儿喂养困难现状研究. 护士进修杂志, 2020, 35(15): 1436-1439.
12. Leitch CA. Growth, nutrition and energy expenditure in pediatric heart failure. Prog Pediatr Cardiol, 2000, 11(3): 195-202.
13. Zhang J, Cui YQ, Ma ZM, et al. Energy and protein requirements in children undergoing cardiopulmonary bypass surgery: Current problems and future direction. JPEN J Parenter Enteral Nutr, 2019, 43(1): 54-62.
14. Zhang M, Wang L, Huang R, et al. Risk factors of malnutrition in Chinese children with congenital heart defect. BMC Pediatr, 2020, 20(1): 213.
15. 戚继荣, 莫绪明, 李荣, 等. 儿童营养风险及发育不良筛查工具用于先天性心脏病患儿围术期营养风险筛查. 中华临床营养杂志, 2014, 22(1): 38-42.
16. 中华医学会小儿外科学分会心胸外科学组, 中华医学会肠外肠内营养学分会儿科学组. 先天性心脏病患儿营养支持专家共识. 中华小儿外科杂志, 2016, 37(1): 3-8.
17. 陈阳, 刘瑞萍, 武海滨. PICU 患儿营养风险筛查及高风险对临床结局的影响. 中国妇幼健康研究, 2020, 31(11): 1537-1540.
18. 冯升, 成磊, 陆华, 等. 两种营养风险筛查工具用于危重患儿诊断效能研究. 护理学杂志, 2018, 33(11): 15-19.
19. 张慧文, 顾莺, 杨玉霞, 等. STAMP 量表筛检住院儿童营养不良风险的系统评价. 护理学杂志, 2016, 31(7): 85-90.
20. 冯升, 成磊, 陆华, 等. 儿科营养不良评估筛查工具用于住院患儿营养风险筛查的诊断效能研究. 护理管理杂志, 2019, 19(4): 233-236.
21. 冯蓓, 梁亚红, 贺婷婷, 等. 2 种营养不良风险筛查工具对儿科住院患儿营养不良风险预测作用的比较. 护理学报, 2020, 27(10): 65-68.
22. 武勰, 刁晓林, 罗启鹏, 等. 围术期白细胞计数对小儿简单先天性心脏病术后严重并发症的预测价值. 中国循环杂志, 2018, 33(S1): 62.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Predictive value of STAMP in Health Information System in children with critical congenital heart disease

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