Introduction: Disease related malnutrition (DRM) is associated with the presence of higher hospital admission, chronic morbidity, increased needs for social resources and also mortality rate. The reported prevalence of undernutrition in pediatric patients hospitalized varies considerably, ranging from 2.5 to 51%. Due to the diversity of the methods used to assess nutritional status and the lack of consensus for defining pediatric undernutrition, it makes a difference in the results. So the use of appropriate nutrition screening tools (NSTs) is important for early detection specially in hospitalized Children. The aim of the study was to evaluate the prevalence of disease related malnutrition and accuracy of
STRONG kids assessment tool for hospitalized children in this country. Method: This cross sectional study was done on tertiary center, Akbar hospital of Mashhad university in Iran. Nutritional risk was evaluated with
STRONG kids assessment tool and anthropometrics assessment (W/A, H/A, BMI/A, MUAC/A Zscore according to the reference curve of WHO). Malnutrition outcome data were evaluated, including length of the hospital stay and number of admission. Result: A total of 200 patients of 8 sub special sections (except ICU and Emergency) that older than one month were included. Mean age of patients were 50.6 month that 60% were male. About 92.9% of which were at nutritional risk (medium or high risk) according to
STRONG kids tool. Anthropometric assessments based on BMI and MUAC showed that about 24.3% and 66% of children were at nutritional risk, that about 12% and 47% were malnutrition (Zscore <-2). Length of hospital stay was related to BMI Zscore and
STRONG kids score. (p<0.05). To evaluate accuracy of assessment tool, sensitivity of 92% and positive predictive value of 77% were detected. Conclusion: Hospitalized Iranian children had higher rates of under-nutrition. STRONGkids tool was able to early identify children at nutritional risk. However, anthropometric evaluations were needed to identify true positives after initial screening.