Résumé
Introduction and aims: The Self Evaluation of Food Intake (SEFI®) is a visual tool to assess food intake and malnutrition risk in adults. The wording and graphics have been adapted for children and adolescents under the name SEFI® Junior (Jr).Aims: to assess the SEFI® Jr reliability to screen for malnutrition in hospitalized children and adolescents (main); the correlation between the SEFI® given by the patient and the parent; iii) if the reason for hospitalization affects the SEFI® Jr diagnosis value (secondary).Methods: Prospective non-interventional multicentre transversal study.Inclusion criteria: age 10-18 years, hospitalization in the Pediatrics or Child Surgery departments of four academic hospitals. The patient and one of her/his parents answered to the SEFI® Jr food intake visual scale blind to each other. Body mass index (BMI) < IOTF curve 18.5 and 17, Waterlow index (WI) < 90 %, height-for-age ratio <95 %, were compared to the score <7 of the SEFI® Jr reported by the child.Statistics: sensitivity (Se), specificity (Spe), positive (PPV) and negative (NPV) predictive values, area under the curve (AUC), Spearman coefficient.Results: 363 patients were included: mean age±SD 13.5 ± 2.1 yr, BMI 19.5 ± 4.3, WI 105.7 ± 26.0, 55 % boys, 61 % chronic diseases, SEFI® Jr 7.8 ± 2.5, <7, n = 107 (29 %). Diagnosis of malnutrition: BMI < IOTF 18.5, n = 69 (19.0 %); BMI < IOTF 17, n = 26 (7.2 %); WI <90 %, n = 95 (26.2 %); height-for-age ratio <95 %, n = 62 (17.1 %). SEFI® Jr feasibility: 100 %. The SEFI® Jr overall performance for malnutrition diagnosis was poor: AUC 0.53 [95 % confidence interval (CI), 0.45-0.61] (vs height-for-age ratio) to 0.62 [0.55-0.68] (vs WI). SEFI® Jr < 7 Spe (71.2-75.8 %), Se (35.5-44.2 %), PPV (9.4-39.3 %), NPV (79.3-93.8 %) varied according to the malnutrition diagnosis criterion. The correlation between the SEFI® scores given by the patient and the parent was high: rho = 0.87, P < 0.0001. SEFI® Jr < 7 performance was the best in children hospitalized for an acute disease: vs BMI IOTF<17 (AUC = 0.74 [0.52-0.96], Spe 65.7, NPV 97.9 %), vs. height-for-age ratio <95 % (AUC = 0.69 [0.54-0.83], Spe 66.7, NPV 89.4 %), vs. IW <90 % (AUC = 0.68 [0.52-0.85], Spe 71.2, NPV 78.7 %).Conclusions: SEFI®Jr is feasible and may be helpful to rule out the diagnosis of malnutrition in children aged 10-18 yr and hospitalized for an acute disease.