Nutrition Risk in Hospitalized Pediatric Patients: Higher Complication Rate and Higher Costs Related to Malnutrition

Abstract

Background Hospitalized children present higher rates of undernutrition. Malnutrition can lead to a more complex hospitalization process with an increased length of stay and higher costs. Our aim was to analyze nutrition risk in hospitalized children and its relationship with clinical outcomes in a tertiary level hospital. Methods This is a single institution prospective observational study. The research involved 282 consecutive children admitted along 3 months. Anthropometric measurements and nutrition risk by means of the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) tool were performed at admission. The incidence of infectious complications, length of hospital stay, weight loss, hospital expenses, and need of nutrition support were recorded. Results The percentage of children with high, moderate, and low nutrition risk was 12.8%, 45%, and 42%, respectively. The prevalence of acute and chronic malnutrition was 13.7% and 7.4%. STRONGkids score correlated with clinical outcomes: longer stay, higher hospital expenses, and need of nutrition support were observed in children with high nutrition risk scores compared with the other groups (P < 0.001). The overall incidence of infectious complications was low (3.5%); a higher STRONGkids score did not predict a higher rate. Conclusion Hospitalized children exposed to high nutrition risk have poorer clinical outcomes: longer stay, higher hospital expenses, and need of nutrition support. More studies are required to assess if applying STRONGkids and starting a nutrition intervention would result in lower costs and a shorter length of stay.

Oral Nutritional Supplementation Improves Growth in Children at Malnutrition Risk and with Picky Eating Behaviors

“…Vulnerability to infectious pathogens is associated with malnutrition-related deficiencies in function of both innate and adaptive immune systems [18,39]. Studies also found that hospitalized pediatric patients have greater complication rates and higher costs when they are malnourished [40]. Further, a recent study examined people who had been picky eaters in childhood with mildly or transiently impaired growth; as young adults, they had lower intake of fruit, vegetables, and whole grains and more frequent intake of snack foods, sugar-sweetened beverages, and high-fat fast-foods, thus setting themselves up for poor health outcomes later in life [41].…”

Sensitivity and specificity test of alarm malnutrition for hospital-acquired malnutrition among pediatric patients

“…13 Another study also mentioned that children with HaM will have approximately 9 days of hospital stay. 14 This study showed that the results of sensitivity and specificity values of STRONGkids were better than Alarm Malnutrition. It indicated that STRONGkids was considered as a good screening tool in detecting the risks for HaM.…”

Risk Factors of Readmission to Pediatric Intensive Care Unit Within 1 Year: A Case-Control Study

“…Higher malnutrition risk is associated with growth impairment, longer LOS, increased hospital costs, and higher mortality ( 28 ). Although few studies have directly confirmed the relationship between malnutrition risk and PICU readmission in adults or children, it has been confirmed that higher malnutrition risk is associated with the occurrence of malnutrition and malnutrition will cause readmission ( 29 ). In recent studies of different nutrition screening tools in pediatrics, StrongKids was considered a method of evaluating good clinical performance ( 30 ).…”