A Scoring System for Classifying Severe Protein-Calorie Malnutrition in Young Children

A simple scoring system can be used in young children to identify the kind of severe protein-calorie malnutrition present.

Patient selection:

(1) selected from Arab children at the Luzmila Hospital in Amman, Jordan from 1963-1966

(2) children < 5 of age

(3) physical signs of malnutrition present: retarded growth, wasting, edema, dermatosis, hair changes, etc.

(4) no complicating non-nutritional diseases

(5) no recent treatment that might affect test findings

Parameters:

(1) edema and dermatitis

(2) hair changes

(3) hepatosplenomegaly

(4) serum albumin, or serum total protein if serum albumin not available

Parameter	Finding	Points
edema and dermatitis	edema plus dermatitis	6
	edema without dermatitis	3
	dermatitis without edema	2
	both absent	0
hair changes	present	1
	absent	0
hepatosplenomegaly	present	1
	absent	0
serum albumin or total serum protein	< 1 g/dL albumin, < 3.25 g/dL total protein	7
	1.00 - 1.49g/dL albumin, 3.25 - 3.99 g/dL total protein	6
	1.50 - 1.99 g/dL albumin, 4.00 - 4.74 g/dL total protein	5
	2.00 - 2.49 g/dL albumin, 4.75 - 5.49 g/dL total protein	4
	2.50 - 2.99 g/dL albumin, 5.50 - 6.24 g/dL total protein	3
	3.00 - 3.49 g/dL albumin, 6.25 - 6.99 g/dL total protein	2
	3.50 - 3.00g/dL albumin, 7.00 - 7.74 g/dL total protein	1
	> 4.0 g/dL albumin, > 7.75 g/dL total protein	0

nutrition score =

= SUM(points for the 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 15

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