International survey among experts on defining and measuring paediatric disease-related malnutrition

Abstract

Objectives and study: A consensus on which criteria to use for defining and measuring diseaserelated malnutrition (DRM) in children has not yet been reached. This survey aimed to 1) inquire which indicators are found to be important by clinical nutrition experts to define malnutrition and malnutrition risk; 2) explore differences across countries and professions. Methods: A web-based questionnaire survey was sent out to paediatric gastroenterologists (MD) and dieticians (RD) in seven countries (the Netherlands, Belgium, UK, Australia, Israel, Spain and Turkey). The survey was distributed via the local professional associations in participating countries. Results: In total, 693 experts (Australia: n=89; Belgium: n=34; Israel: n=126; the Netherlands: n=73; Spain: n=139; Turkey: n=79; UK: n=153) responded; 45.5% were MD and 54.5% RD with a different distribution of professions across countries (p<0.001). No Belgian RD's were included. MD's and RD's had respectively a median of 15 (10;25) and 9 (3;14) years' experience in paediatrics. The majority worked in a tertiary (50.6%) and/or district general hospital (33.3%), with differences noted across countries. Suboptimal intake was ranked the most important cause (1st out of 4 possibilities) of malnutrition by 44.9% of the respondents, but also the least important by 16.8%; inflammatory response was considered the least important cause by 42.7% and the most important by 13.4%. Significant differences existed across countries and profession (p<0.01). Table 1 shows how often experts rate certain findings as highly important or as not/slightly important in relation to the definition and criteria of DRM. Conclusion: Suboptimal intake was considered the most important cause of malnutrition for half out of the 700 international field experts. On-going weight loss, increased energy/nutrient losses, low energy/macronutrient intake and abnormal blood parameters were estimated as highly important indicators of malnutrition/malnutrition risk by half or more of the respondents. Across-country differences were noted for nearly all questions, suggesting difficulties in reaching international consensus.L6167775342017-06-16 <br />