{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:45:33Z","timestamp":1788349533946,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malnutrition during cancer treatment increases treatment\u2010related morbidity and mortality. Our study better characterizes variability in malnutrition identification and treatment by examining nutrition\u2010related diagnoses and support for children with central nervous system (CNS) and non\u2010CNS solid tumors during therapy. We examined diagnosis of malnutrition, use of tube feeding or parenteral nutrition (PN), and appetite stimulants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 0 to 21\u2010year\u2010old patients in the Pediatric Health Information System from 2015 to 2019. Patients were classified as having (1) billed malnutrition diagnosis, (2) malnutrition diagnosis or using PN and enteral nutrition (\u201cfunctional malnutrition\u201d), and (3) any previous criteria or prescribed appetite stimulants (\u201cpossible malnutrition\u201d), as well as associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 13,375 unique patients, CNS tumors were most common (24.4%). Overall, 26.5% of patients had malnutrition diagnoses, 45.4% met functional malnutrition criteria, and 56.0% had possible malnutrition. Patients with adrenal tumors had highest billed, functional, and possible malnutrition (36.6%, 64.1%, and 69.4%, respectively) followed by CNS tumors (29.1%, 52.4%, and 64.1%). Patients with adrenal tumors had highest rates of PN use (47.4%) and those with CNS tumors had the highest tube feeding use (26.8%). Hospital admissions with malnutrition had a longer hospital length of stay (LOS) (6 vs 3 days,\n                      <jats:italic>P\u2009<\/jats:italic>\n                      &lt;\u20090.0001), more emergency department admissions (24.4% vs 21.8%,\n                      <jats:italic>P\u2009<\/jats:italic>\n                      &lt;\u20090.0001), and more opioid use (58.6% vs 41.4%,\n                      <jats:italic>P\u2009<\/jats:italic>\n                      &lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Variability in malnutrition diagnoses hinders clinical care and nutrition research in pediatric oncology. Improving disease\u2010specific recognition and treatment of malnutrition can target nutrition support, ensure appropriate reimbursement, and potentially improve outcomes for children with solid tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpen.2329","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T02:44:16Z","timestamp":1642473856000},"page":"1559-1567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Malnutrition identification and management variability: An administrative database study of children with solid tumors"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1018-9914","authenticated-orcid":false,"given":"Daniel V.","family":"Runco","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children at IU Health Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Stanek","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology &amp; Bone and Marrow Transplant, Nationwide Children's Hospital Columbus Ohio USA"},{"name":"Biostatistics Resource at Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas D.","family":"Yeager","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology &amp; Bone and Marrow Transplant, Nationwide Children's Hospital Columbus Ohio USA"},{"name":"Department of Pediatrics The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Belsky","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children at IU Health Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-014-2350-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24409"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.06.017"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607109341804"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.03.015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10200"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2020.05.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgz025"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533614557642"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116633800"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgz018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533616671861"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00611"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24426"},{"issue":"3","key":"e_1_2_10_16_1","first-page":"Cd007904","article-title":"Enteral 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