The STRONGkids is a nutritional screening tool for hospitalized children, which was found to predict a negative weight for height (WFH) standard deviation score (SDS) and a prolonged hospital length of stay (LOS) in a Dutch population of hospitalized children. This study aimed to test the ease of use and reproducibility of the STRONGkids, and to confirm its concurrent and prospective validity in a Belgian population of hospitalized children.


Reproducibility was tested in a cohort of 29 hospitalized children in a tertiary center and validity was tested in 368 children (105 hospitalized in a tertiary and 263 in three secondary hospitals) ages between 0.08 and 16.95 y (median 2.2 y).


Substantial intrarater (? = 0.66) and interrater (? = 0.61) reliabilities were found between observations. STRONGkids scores correlated negatively with WFH SDS of the patients (? = -0.23; P <0.01; odds ratio [OR], 2.47; 95% confidence interval [CI], 1.11-5.49; P <0.05). It had a sensitivity and negative predictive value (NPV) of respectively 71.9% and 94.8% to identify acutely undernourished children. STRONGkids did not correlate with weight loss during hospitalization, but correlated with LOS (? = 0.25; OR 1.96; 95% CI, 1.25-3.07; both P <0.01) and the set-up of a nutritional intervention during hospitalization (OR, 18.93; 95% CI, 4.48-80.00; P <0.01). The sensitivity and NPV to predict a LOS ? 4 d were respectively 62.6% and 72%, and respectively 94.6% and 98.9% to predict a nutritional intervention.


STRONGkids is an easy-to-use screening tool. Children classified as "low risk" have a 5% probability of being acutely malnourished, with only a 1% probability of a nutritional intervention during hospitalization.
Original languageEnglish
Pages (from-to)1356-1361
Number of pages6
Publication statusPublished - 30 Nov 2013

    Research areas

  • child, hospitalized

ID: 2414368