Pilot links pediatric malnutrition screening with longer hospital stays

A pilot study of 100 children hospitalized at a tertiary university hospital in Türkiye found that high Pediatric Yorkhill Malnutrition Score (PYMS) classifications and moderate malnutrition classifications based on mid-upper arm circumference (MUAC) were associated with longer hospital stays. The investigation, conducted from January through July 2024, included 50 girls and 50 boys aged one month to 18 years. Researchers assessed nutritional status using World Health Organization (WHO) anthropometric Z-scores and examined the predictive validity of PYMS and age-adjusted MUAC as rapid screening tools.

The study documented what the authors described as a “double burden of malnutrition,” with 13.0% of the hospitalized children classified as acutely malnourished and 11.0% as chronically malnourished, or stunted. At the other end of the nutritional spectrum, among children aged 5 to 18 years, 34.5% were overweight and 21.8% were obese. These percentages characterize the study sample rather than the prevalence of malnutrition among all children in Türkiye.

The pilot was conducted in one hospital, included only 100 participants and was intended to provide information for a later large-scale, school-based screening effort. Among children older than five years, MUAC Z-scores were significantly correlated with body mass index Z-scores (p < 0.05). Length of stay differed significantly between several groups classified by the screening tools.

Children in the PYMS high-risk group had longer hospital stays than those in the low-risk group (p = 0.001). Children classified as moderately malnourished by MUAC also had significantly longer stays (p < 0.05). These results show an association between nutritional-risk classifications and hospitalization duration; they do not establish that malnutrition or the act of screening caused the longer admissions.

The researchers also developed a socioeconomic malnutrition-risk classification based on household income, family size and maternal employment status. Children classified as high risk by this model had significantly lower height-for-age Z-scores than other children (p < 0.05). The observation connects household circumstances measured by the classification with poorer linear growth in this sample, but it does not demonstrate that those circumstances directly caused the difference.

Overall, the pilot provides preliminary evidence for PYMS and MUAC as practical screening measures associated with nutritional risk and prolonged hospitalization, while the sample size, single-center setting and limited sensitivity of PYMS for stunting constrain broader conclusions.

Subject of Research: Pilot evaluation of PYMS and MUAC nutritional screening in 100 hospitalized children in Türkiye

Article Title: Combined use of the pediatric Yorkhill malnutrition score and mid-upper arm circumference for identifying nutritional risk and predicting length of hospital stay in hospitalized children: a pilot study

Article References: Çelik, E., Korkmaz, M. F., Özkaya, Y., Yüce, S., Soyubelli, T. D., & Tutanç, M. (2026). Combined use of the pediatric Yorkhill malnutrition score and mid-upper arm circumference for identifying nutritional risk and predicting length of hospital stay in hospitalized children: a pilot study. BMC Pediatrics, 26(1), Article 905. https://doi.org/10.1186/s12887-026-07609-5

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07609-5

Keywords: pediatric malnutrition, hospitalized children, PYMS, mid-upper arm circumference, anthropometric Z-scores, childhood stunting, acute malnutrition, hospital length of stay, socioeconomic risk, Türkiye, Combined, pediatric