Your browser doesn't support javascript.
loading
Examining Mid-Upper Arm Circumference Malnutrition z-Score Thresholds.
Stephens, Karen; Orlick, Meike; Beattie, Shannon; Snell, Audrey; Munsterman, Kim; Oladitan, Leah; Abdel-Rahman, Susan.
Afiliação
  • Stephens K; Nutrition Services, Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Orlick M; Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Beattie S; Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Snell A; Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Munsterman K; Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Oladitan L; Children's Mercy Hospital, Kansas City, Missouri, USA.
  • Abdel-Rahman S; UMKC School of Medicine, Kansas City, Missouri, USA.
Nutr Clin Pract ; 35(2): 344-352, 2020 Apr.
Article em En | MEDLINE | ID: mdl-31175704
BACKGROUND: Anthropometric z-scores used commonly for diagnosis and determining degree of malnutrition, specifically body mass index (BMIz), weight-for-length (WLz), and mid-upper arm circumference (MUACz), are not wholly concordant, yet the proposed thresholds for classification are identical. This study was designed to critically examine MUACz thresholds and their ability to correctly classify nutrition status. METHODS: This was a 2-year, prospective single-center study of children ≤18 years seen by registered dietitians within a large pediatric institution. The sensitivity, specificity, and predictive performance of the malnutrition classification thresholds were estimated against clinician-based classification. RESULTS: Sixty-one dietitians enrolled 10,401 patients with distributions of z-scores for weight (-0.5 ± 1.9), length (-0.8 ± 1.6), BMI or WL (-0.1 ± 1.8), and MUAC (-0.4 ± 1.5), suggesting participants were smaller and shorter than the reference U.S. POPULATION: Distributions of MUACz were broad and overlapped between nutrition classification groups, an observation that extended to BMIz and WLz as well. Consequently, existing thresholds do not accurately classify 100% of children. Misclassification rates increase, with increasing severity ranging from 8% in children with no malnutrition to 71% in children with severe malnutrition. Algorithm- and manually-based refinement of thresholds result in mixed improvements and can be explored by the reader with the associated supplement. CONCLUSION: The sensitivity of proposed MUACz thresholds systematically decreases with increasing severity of malnutrition and will require optimization if we aim to limit the number of children at risk of misclassification. Indicators for overnutrition remain to be addressed but are explored herein.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Braço / Antropometria / Desnutrição Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Braço / Antropometria / Desnutrição Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Ano de publicação: 2020 Tipo de documento: Article