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      Adaptación en español y validación en México de la herramienta de tamizaje nutricional STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics) Translated title: Adaptation in Spanish and validation in Mexico of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP)

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          Abstract

          Resumen Antecedentes: la desnutrición pediátrica es una de las principales causas de complicaciones en niños hospitalizados, por ello, el tamizaje nutricional al ingreso es indispensable. La Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) es una herramienta sencilla, reproducible y fácil de interpretar, sin embargo, en México no se encuentra validada. El objetivo del estudio fue validar y adaptar a la población mexicana la herramienta de tamizaje nutricional STAMP. Metodología: la validación se realizó en dos fases: en primer lugar, se realizó la traducción y adaptación cultural; y en segundo lugar, se llevó a cabo un estudio transversal comparando la herramienta STAMP con una evaluación nutricional completa (ENC). Un médico pediatra especialista en nutrición realizó la ENC con la evaluación de parámetros antropométricos, clínicos y dietéticos y, posteriormente, dos nutriólogas realizaron la misma evaluación con la herramienta STAMP. Finalmente, se tamizaron todos los pacientes en leve y moderado o grave riesgo de desnutrición. Resultados: de los 300 pacientes incluidos en el estudio, 160 fueron niños (53,3 %) y 140, niñas (46,7 %), con una media de edad de 9,44 ± 5,73 años. Las valoraciones realizadas con la herramienta STAMP tuvieron una concordancia del 100 %. Comparado con la ENC, se obtuvo un índice kappa de 0,480 (p < 0,01). La prueba STAMP mostró una sensibilidad del 92 %, una especificidad del 75 %, valor predictivo positivo (VPP) del 45 %, valor predictivo negativo (VPN) del 97 %, LR- de 3,68 y LR- de 0,10. Conclusiones: la herramienta de tamizaje STAMP cuenta con los elementos necesarios para evaluar de forma objetiva el riesgo de desnutrición en niños mexicanos y es una prueba altamente sensible y específica.

          Translated abstract

          Abstract Background: pediatric malnutrition is one of the main causes of complications in hospitalized children. Nutritional screening at admission is essential. The Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) is a simple, reproducible and easy-to-interpret tool, but it is not validated in Mexico. The objective of the study was to validate and adapt the STAMP nutritional screening tool to the Mexican population. Methods: the validation was carried out in two phases: firstly, the translation and cultural adaptation was carried out; and secondly, a cross-sectional study was performed comparing the STAMP tool with a complete nutritional assessment (CNA). A pediatrician specialized in nutrition performed the CNA with the evaluation of anthropometric, clinical and dietary parameters; later, two nutritionists carried out the same evaluation with the STAMP tool. Finally, the patients were graded as low risk and moderate or severe malnutrition risk. Results: of the 300 patients included in the study, 160 were boys (53.3 %) and 140 were girls (46.7 %), with a mean age of 9.44 ± 5.73 years. The assessments made by with the STAMP tool had a 100 % concordance. Compared with CNA, a kappa index of 0.480 (p < 0.01) was obtained. The STAMP test showed a sensitivity of 92 %, a specificity of 75 %, positive predictive value (PPV) of 45 %, negative predictive value (NPV) of 97 %, RVN of 3,68, and RVN of 0,10. Conclusions: the STAMP screening tool has the necessary elements to objectively assess the risk of malnutrition in Mexican children and is a highly sensitive and specific test.

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          Most cited references18

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          ESPEN guidelines on definitions and terminology of clinical nutrition.

          A lack of agreement on definitions and terminology used for nutrition-related concepts and procedures limits the development of clinical nutrition practice and research.
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            ESPEN guidelines for nutrition screening 2002.

            To provide guidelines for nutrition risk screening applicable to different settings (community, hospital, elderly) based on published and validated evidence available until June 2002. NOTE: These guidelines deliberately make reference to the year 2002 in their title to indicate that this version is based on the evidence available until 2002 and that they need to be updated and adapted to current state of knowledge in the future. In order to reach this goal the Education and Clinical Practice Committee invites and welcomes all criticism and suggestions (button for mail to ECPC chairman).
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              Severe childhood malnutrition

              The main forms of childhood malnutrition occur predominantly in children <5 years of age living in low-income and middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use the term ‘severe malnutrition’ to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                April 2023
                : 40
                : 2
                : 354-361
                Affiliations
                [1] Ciudad de México orgnameHospital General de México Dr. Eduardo Liceaga orgdiv1Servicio de Pediatría México
                [5] Ciudad de México orgnameUniversidad Autónoma de Nuevo León orgdiv1Facultad de Salud Pública y Nutrición (FASPyN) Mexico
                [3] Ciudad de México orgnameHospital General de México Dr. Eduardo Liceaga orgdiv1Servicio de Nutrición Clínica México
                [2] Ciudad de México orgnameHospital General de México Dr. Eduardo Liceaga orgdiv1Dirección de Investigación orgdiv2Laboratorio de Proteómica y Metabolómica México
                [4] Ciudad de México orgnameHospital Infantil de México Federico Gómez orgdiv1Servicio de Epidemiología Clínica México
                Article
                S0212-16112023000300017 S0212-1611(23)04000200017
                10.20960/nh.04333
                bf6cfaf4-80f6-4297-bb59-14feb3cb44ae

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 29 June 2022
                : 15 January 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 8
                Product

                SciELO Spain

                Categories
                Trabajos Originales

                Malnutrition,Evaluación nutricia,Riesgo nutricional,Desnutrición,Tamizaje,Nutritional evaluation,Screening,Nutritional risk

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