Hospital-acquired malnutrition in children at a tertiary care hospital

Abstract

a tertiary care hospital. Subjects: One hundred and seventy children who met the inclusion criteria were included in the study. Outcome measures: Anthropometry was done at admission and discharge. Incidence of hospital-acquired malnutrition was estimated from the total number of children showing a decrease in weight-for-height/length (WFH) or Body Mass Index (BMI) z-scores from the time of admission to discharge. Logistic regression analysis was performed to determine associations between selected variables and weight loss during hospitalisation. Results: Albeit a borderline level of significance, a decrease in calculated z-scores occurred in 60.6% (Confidence Interval (CI) 53.1-67.6%) of children during hospitalisation with a mean weight decrease of 0.5 kg (Standard Deviation (SD) ± 3.37, p = 0.055). Children ≤ 60 months of age demonstrated a mean decrease in weight-for-height/length z-score of 0.145 (SD ± 0.73, p = 0.042); and those > 60 months, a mean decrease in BMI z-score of 0.152 (SD ± 0.39, p = 0.004). The majority with weight loss had been admitted with a diagnosis of gastroenteritis (81.2%), gastritis (64.3%) and pneumonia (55.6%). Weight loss was associated with duration of admission: 3 -5 days (Odds Ratio (OR) 2.43, CI 1.46-4.03), 5 -7 days (OR 4.67,, and > 7 days (OR 2.75,; score test for trend of odds is OR 1.37 (95% CI 1.11-1.69, p = 0.003). Conclusion:This study found a high incidence of hospital-acquired malnutrition in children. The most affected were those with gastroenteritis, gastritis and pneumonia. Hospital-acquired malnutrition was associated with an increased duration of hospitalisation.

Malnutrition;

“…It was observed that 91% of children with NRS-4, during a period of 1 st week of hospitalization stay; lost more than 2% of their reference weight while 84% of children with NRS-5 lost more than 2% of reference weight. 16 Our results were in concordance with other studies conducted world wide. 10 There is huge amount of malnutrition in hospitalized children and this malnutrition worsens further during hospital stay if appropriate measures are not opted.…”

Design Child-friendly Food Guide Based on Nutritional Risk Assessment of Pediatric Inpatients

“…Others have found that a hospital stay for more than five days is considered a risk factor for malnutrition. [26,27,28] The length of hospital stay is multifactorial. The introduction of ordinary meals is often postponed, and fewer children receive food on the first day of their hospitalization.…”

Tinjauan Literatur Malnutrisi Didapat di Rumah Sakit: Karakteristik Anak dan Alat Skrining yang Digunakan

“…Penelitian lain mengatakan malnutrisi didapat di rumah sakit adalah penurunan berat badan sebesar > 2% atau penurunan indeks masa tubuh (IMT) ≥ 0,25% yang dapat dihitung setelah masa rawat > 72 jam (8) . Malnutrisi didapat di rumah sakit dapat dinilai pada anak usia 29 hari setelah lama rawat ≥ 48 jam atau sesaat sebelum pulang dan biasanya anak akan mengalami penurunan berat badan sekitar 0,5 kg per hari atau sekitar 0,17% dari berat badan sebelumnya (20) .…”

“…Selanjutnya data prevalensi anak di rumah sakit di Southern Ethiopia juga terdapat perbedaan yaitu sebanyak 58,75% pada usia <24 bulan dan 41,25% pada usia >24 bulan (22) . Data kejadian malnutrisi didapat di rumah sakit memang terbilang banyak pada usia < 5 tahun, hal ini didukung oleh penelitian yang dilakukan di rumah sakit di Kenya dimana rata-rata usia partisipan yang ada dalam penelitian adalah sebanyak 39,5 bulan atau 3 tahun 3 bulan (20) .…”

“…Selain karakteristik usia, data prevalensi malnutrisi di rumah sakit di Bergia juga berbeda antara laki-laki dan perempuan yaitu sebanyak 57,4% dan 42,6% (23) . Dimana data ini didukung dengan penelitian yang dilakukan di Nairobi Kenya terdapat perbedaan rata-rata jenis kelamin antara laki-laki sebanyak 52,9% dan perempuan sebanyak 47,1% (20) . Sehingga berdasarkan data maka kasus prevalensi kejadian malnutrisi di rumah sakit lebih banyak pada laki-laki dibandingkan perempuan yaitu sebanyak 1,6:1 (6) .…”