{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:21:19Z","timestamp":1790270479840,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"\n Objective<\/jats:title>\n The objective of this paper was to understand the nutritional status of hospitalized children and explore the clinical application value of the modified STRONGkids and PYMS screening tools.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Nutritional risk screening was performed using the modified STRONGkids and PYMS tools on 302 children admitted to the pediatric department of our hospital between April 2021 and March 2023. Differences in clinical outcomes and biochemical indicators under different nutritional statuses were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, 302 children were included in the current study. The modified STRONGkids screening tool identified 18 (5.96%) children at high risk of malnutrition, 210 (69.54%) at moderate risk, and 74 (24.50%) at low risk. The PYMS screening tool identified 16 (5.30%) children at high risk, 152 (50.33%) at moderate risk, and 134 (44.37%) at low risk. According to WHO nutritional assessment standards, 150 (49.67%) children were identified as borderline malnourished or malnourished. Both the modified STRONGkids and PYMS evaluations indicated that children with digestive system diseases had a significantly higher risk of malnutrition compared with those who had other systemic diseases. Moreover, children under 1 year of age had a significantly higher risk of malnutrition compared with other age groups (\n P<\/jats:italic>\n \u2009&lt;\u20090.05). High-risk children identified by both screening methods had higher rates of hospital-acquired infections, longer hospital stays, and lower levels of hemoglobin and prealbumin compared with those at moderate and low risk (\n P<\/jats:italic>\n \u2009&lt;\u20090.05). The modified STRONGkids tool demonstrated higher sensitivity and accuracy in predicting malnutrition in hospitalized children compared than the PYMS tool (\n P<\/jats:italic>\n \u2009&lt;\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Children with digestive system diseases and those under 1 year of age are at high risk for malnutrition. Both the modified STRONGkids and PYMS tools can effectively identify children at risk of malnutrition, with the modified STRONGkids tool demonstrating better application results.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2025.1628856","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T06:51:14Z","timestamp":1770879074000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Modified STRONGkids outperforms PYMS for WHO-defined malnutrition: a screening-to-action pathway for pediatric wards"],"prefix":"10.3389","volume":"13","author":[{"given":"Hong","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Wenzhou People\u2019s Hospital","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wenzhou People\u2019s Hospital","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wenzhou People\u2019s Hospital","place":["Wenzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1097\/MCO.0000000000000644","article-title":"Pediatric screening tools for malnutrition: an update","volume":"23","author":"Hulst","year":"2020","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.26355\/eurrev_201901_17009","article-title":"Impact of malnutrition on survival and infections among pediatric patients with cancer: a retrospective study.","volume":"23","author":"Triarico","year":"2019","journal-title":"Eur Rev Med Pharmacol Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13643-020-01309-6","article-title":"Mapping evidence on malnutrition screening tools for children under 5 years in sub-Saharan Africa: a scoping review protocol","volume":"9","author":"Maphosa","year":"2020","journal-title":"Syst Rev"},{"key":"B4","first-page":"184","article-title":"Application research of STRONGkids in nutritional risk screening of hospitalized children in rehabilitation medicine","volume":"43","author":"Ling","year":"2021","journal-title":"Beijing Med J"},{"key":"B5","first-page":"65","article-title":"Study on the impact of nutritional risk on the prognosis of children with severe sepsis","volume":"22","author":"Xiaoqin","year":"2021","journal-title":"J Clin Emerg"},{"key":"B6","first-page":"264","volume-title":"Pediatrics","author":"Weiping","year":"2013"},{"key":"B7","first-page":"233","article-title":"Application of STRONGkids tool for nutritional screening and its possible impact on clinical outcomes in infants and young children with lower respiratory tract infections","volume":"27","author":"Dan","year":"2019","journal-title":"Chin J Clin Nutr"},{"key":"B8","first-page":"528","article-title":"Clinical application of nutritional assessment and nutritional risk screening tools for critically ill children","volume":"21","author":"Junying","year":"2019","journal-title":"Chin J Contemp Pediatr"},{"key":"B9","first-page":"13","volume-title":"WHO Child Growth Standards Length\/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age: Methods and Development","year":"2006"},{"key":"B10","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.anpedi.2019.01.014","article-title":"Influencia del estado nutricional en la evoluci\u00f3n cl\u00ednica del ni\u00f1o hospitalizado [Influence of nutritional status on clinical outcomes in hospitalised children]","volume":"91","author":"P\u00e9rez Moreno","year":"2019","journal-title":"An Pediatr (Engl Ed)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/tropej\/fmy009","article-title":"Validation of the subjective global nutrition assessment (SGNA) and screening tool for the assessment of malnutrition in paediatrics (STAMP) to identify malnutrition in hospitalized Malaysian children","volume":"65","author":"Ong","year":"2019","journal-title":"J Trop Pediatr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1002\/ncp.10367","article-title":"Screening for pediatric malnutrition at hospital admission: which screening tool is best","volume":"35","author":"Carter","year":"2020","journal-title":"Nutr Clin Pract"},{"key":"B13","first-page":"85","article-title":"Nutritional risk screening and clinical outcome analysis of hospitalized children in neonatal surgery","volume":"26","author":"Lulu","year":"2020","journal-title":"Chin J Food Nutr"},{"key":"B14","first-page":"779","article-title":"Nutritional risk screening and nutritional status evaluation of 5236 hospitalized children","volume":"50","author":"Xinyin","year":"2019","journal-title":"J Sichuan Univ"},{"key":"B15","first-page":"5742","article-title":"The predictive value of STRONGkids screening for nutritional risk in hospitalized children in primary hospitals and its correlation with clinical outcomes","volume":"36","author":"Mingmei","year":"2021","journal-title":"Chin J Matern Child Health"},{"key":"B16","first-page":"377","article-title":"Comparative study of STRONGkids, PYMS, and STAMP in nutritional risk screening of hospitalized children with burns","volume":"44","author":"Lingyan","year":"2022","journal-title":"Chin J Nutr"},{"key":"B17","first-page":"248","article-title":"Application evaluation of two nutritional risk screening tools for hospitalized children with digestive system diseases","volume":"28","author":"Xiaoying","year":"2023","journal-title":"Modern Digest Interv Diagn Treatment"},{"key":"B18","first-page":"556","article-title":"Nutritional risk screening and influencing factors in hospitalized children with hematological malignancies","volume":"40","author":"Huina","year":"2019","journal-title":"J Hebei Med Univ"},{"key":"B19","first-page":"779","article-title":"Nutritional risk screening and clinical significance of children with severe pneumonia","volume":"27","author":"Lingling","year":"2019","journal-title":"Chin J Childrens Health"},{"key":"B20","first-page":"96","article-title":"Application of data standardization processing in nutritional status analysis and malnutrition risk screening of children with acute lymphocytic leukemia","volume":"27","author":"Xiuhua","year":"2019","journal-title":"Chin J Clin Nutr"},{"key":"B21","first-page":"337","article-title":"Nutritional risk assessment and clinical outcome correlation analysis of children with malignant tumors using STAMP","volume":"26","author":"Xianmei","year":"2021","journal-title":"Chin J Pediatr Hematol Oncol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1628856\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:26:51Z","timestamp":1771928811000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1628856\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":21,"alternative-id":["10.3389\/fped.2025.1628856"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1628856","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]},"article-number":"1628856"}}