Influence of nutritional status on clinical outcomes in hospitalised children

Pérez-Moreno, Jimena; Navazo, Sara de la Mata; Arteta, Estíbaliz López-Herce; Hernani, Mar Tolín; Martínez, Felipe González; Sánchez, María Cristina Polo; Fernández, R. Rodríguez

doi:10.1016/j.anpede.2019.09.003

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Patients with pediatric intestinal pseudo‐obstruction are at risk for malnutrition due to various factors including poor tolerance of enteral feeds, underlying comorbid conditions, etc The prevalence of malnutrition in our cohort was similar to that previously reported for hospitalized pediatric patients, which ranges between 5%‐60% . Importantly, we found that the presence of malnutrition in our cohort resulted in higher healthcare burden, consistent with previous studies . Unfortunately, while retrospective studies have elucidated the association between poor nutritional status and increased healthcare utilization, there is still a need for prospective studies to fully establish this association …”

Section: Discussionsupporting

confidence: 90%

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Batra

Rahman

Rana

et al. 2019

Neurogastroenterology Motil

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Background Pediatric intestinal pseudo‐obstruction is a rare disorder affecting gastrointestinal motility leading to chronic symptoms and hospitalizations. There is limited understanding of the epidemiology and healthcare burden. Methods We analyzed data from Kids' Inpatient Database from 2016, which includes inpatient discharge records from US hospitals. ICD‐10 codes were used to identify patients 0‐18 years with pediatric intestinal pseudo‐obstruction and comorbid conditions. Multivariable logistic regression and Wilcoxon rank‐sum test were used. Results In 2016, there were 1671 inpatient discharges from US hospitals for patients 0‐18 years of age with this diagnosis. The incidence of inpatient admission was 29/100 000 patients. After controlling for age, race, income status, and insurance, males vs females (adjusted odds ratio, aOR: 1.10; 95% CI: 0.94‐1.28; P = .241) and caucasians vs other races (aOR: 1.55; 95% CI: 1.27‐1.88; P < .001) were more likely to be admitted. Inpatient admissions incurred significant healthcare burden; median (inter quartile range IQR) cost of hospitalization of US$ 52 079 (US$ 23 530‐120 961) and a median (IQR) length of stay of 6 days (3‐14 days). Gastrostomy (32%) and ileostomy (12.6%) status appeared to incur lower healthcare burden. Parenteral nutrition, malnutrition, and central line/bloodstream infections resulted in higher healthcare burden. Conclusions Pediatric intestinal pseudo‐obstruction is a rare diagnosis with a high incidence of inpatient admissions and healthcare burden. An aggressive multidisciplinary management is crucial in reducing inpatient admissions in this cohort.

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Section: Discussionsupporting

confidence: 90%

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Batra

Rahman

Rana

et al. 2019

Neurogastroenterology Motil

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“…Sendo observado que 1,5% apresentaram desnutrição grave, comparado ao percentual de sobrepeso/obesidade de 45,5%. Contudo em mesmo estudo, foi visto um alto risco nutricional (48,3%), avaliado pela ferramenta de triagem nutricional STAMP, validado para uso em crianças espanholas 16 .…”

Section: Discussionunclassified

“…Entre os diagnósticos mais frequentes encontrados no estudo atual, estavam as doenças respiratórias como bronquiolites e pneumonias, assim como observado em estudo realizado em Salvador-BA em um hospital público, onde as afecções do trato respiratório foram mais frequentes (35,4%) 4 . Concordando com dados do estudo de Pérez Moreno et al (2019), com crianças internadas em hospital terciário na Espanha, onde o diagnóstico mais frequente foi a doença respiratória aguda (68%) 16 . Enquanto que em estudo de Silva et al (2021), foi visto as doenças neurológicas (38,6%), seguidas das respiratórias (27,5%) 2 .…”

Section: Discussionunclassified

Evolução do estado nutricional de lactentes hospitalizados em uso de terapia nutricional enteral

Silva,

Neves,

De Lima

et al. 2023

Braz. J. Develop.

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A terapia nutricional enteral (TNE) é uma estratégia que possibilita a manutenção ou recuperação do estado nutricional de indivíduos com ingestão oral comprometida, que apresentem o trato gastrointestinal (TGI) funcionante. O objetivo do presente estudo foi avaliar a evolução nutricional de crianças em uso de TNE hospitalizadas em um hospital de referência no Nordeste. Trata-se de um estudo observacional, prospectivo, do tipo descritivo e com uma abordagem quantitativa, com pacientes pediátricos internados na enfermaria clínica médica pediátrica do Instituto de Medicina Integral Professor Fernando Figueira (IMIP), de ambos os sexos entre as idades de 0 a 2 anos, que se encontraram em uso de TNE. Para análise estatística foi utilizado para o programa Statistical Package for Social Science- SPSS for Windows, versão 13.0 (SPSS Inc., Chicago, IL). As variáveis contínuas foram testadas quanto à normalidade da distribuição, pelo teste de Kolmogorov-Smirnov. As variáveis com distribuição normal tiveram suas médias comparadas pelos testes de “t” Student (duas variáveis) e ANOVA (mais de duas variáveis), quando os critérios de normalidade não foram atingidos foi utilizado o teste de Wilcoxon pareado. Foi observado uma prevalência de desnutrição na população estudada, com uma evolução do estado nutricional nos dois momentos de avaliação nutricional, havendo uma recuperação ponderal e redução da prevalência de desnutrição. Assim, foi demostrado que o peso de acompanhamento foi estatisticamente maior que o peso de admissão. Houve ainda associação significativa entre a indicação de TNE e o diagnóstico clínico.

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“…Malnutrition in hospitalized children is associated with unfavorable clinical outcomes and more extended hospital stays and greater disease severity Niseteo et al (2020). Therefore, it is essential to assess nutritional status and nutritional risk at hospital admission, so that dietary interventions can be performed early on patients at risk of malnutrition Moreno et al (2019); Beser et al (2018).…”

Section: Introductionmentioning

confidence: 99%

Acute malnutrition is associated with the high nutritional risk obtained by STRONGkids in children and adolescents with infectious diseases

Silva

Sousa

Pinheiro

et al. 2021

RSD

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Objective: In this study, we aim to evaluate whether the presence of malnutrition in children and adolescents with infectious diseases is associated with high nutritional risk obtained by the STRONGkids instrument. Methods: A cross-sectional study comprising 237 hospitalized patients aged between 30 days and 18 years. Identification and diagnosis data, weight and height were collected. STRONGkids determined nutritional risk. Acute malnutrition was classified by BMI/age Z score < - 2 and chronic by Height/age Z score < - 2. Associations between categorical variables were verified using Pearson's chi-square test. A logistic regression analysis was performed to assess the association between anthropometric parameters of malnutrition and nutritional risk. It was considered significant p< 0,05. Results: In multiple analysis, it was observed that having malnutrition as of BMI/age increases the chance by 5.68 of having high nutritional risk by the STRONGKids instrument, regardless of age, sex and the presence of poverty-related infectious diseases (OR: 5.68; 95% CI: 1.54-20.93; p=0.009). Conclusion: In summary, for patients with infectious diseases, acute malnutrition (BMI/age) is associated directly with the diagnosis of high nutritional risk by STRONGkids.

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Influence of nutritional status on clinical outcomes in hospitalised children

Cited by 7 publications

References 25 publications

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Epidemiology and healthcare utilization of inpatient admissions in children with pediatric intestinal pseudo‐obstruction

Evolução do estado nutricional de lactentes hospitalizados em uso de terapia nutricional enteral

Acute malnutrition is associated with the high nutritional risk obtained by STRONGkids in children and adolescents with infectious diseases

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