The impact of body mass index on resource utilization and outcomes of children admitted to a pediatric intensive care unit

Sharma, Kamal; Raszynski, André; Totapally, Balagangadhar

doi:10.1177/2050312119825509

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…Classification of the study population based on patients' BMI showed that they had a normal weight (61.5%). A similar outcome has been reported by Kamal Sharma et al [11], in which patients with normal weight were also dominant (61.5%). This may suggest that there is not a significant difference in the risk of occurring infectious diseases between underweight, normal weight, and obese children.…”

Section: Discussionsupporting

confidence: 88%

Assessment of Antibiotic Usage Pattern in Patients of Pediatric Department-a Prospective Study

Nazi

Anisha

Ghanbarlou

2021

Int J Pharm Pharm Sci

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Objective: The study aimed to assess the antibiotic usage pattern in patients of the pediatric department in ESI Hospital, Indiranagar, Bangalore. Methods: A prospective six-month observational study was conducted in the pediatric department. The history of the patients was collected from the case sheets and the patient demographic details were also collected. The details of antibiotics prescribed and the other therapy applied to the patients were collected in terms of dosage, duration, and route of administration. The antibiotic consumption was assessed based on qualitative and quantitative indicators which assess the appropriateness of antibiotic use, and the dosage of antibiotics prescribed, respectively. Regarding the qualitative evaluation of antibiotic consumption, the World Health Organization (WHO) guideline was considered to appraise compliance with indication and dosing. Results: Distribution of drug prescription indicators showed that the average number of drugs per encounter was 3.7, which is more than the standards suggested by WHO and should be reduced as much as possible to mitigate polypharmacy and its consequences. 93.45% of encounters existed leastwise with one or more antibiotics, which was higher than the WHO standards. Almost 56.08% of drugs were prescribed considering their generic name, which was very much lower than the ideal percentage recommended by WHO. Conclusion: The percentage of encounters with one or more antibiotics was very higher than the WHO standard percentage, which indicates the irrationality of antibiotic prescribing. To minimize the irrationality of prescriptions and their inappropriateness, effective interventions and compliance with antibiotic prescribing guidelines are required.

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Section: Discussionsupporting

confidence: 88%

Assessment of Antibiotic Usage Pattern in Patients of Pediatric Department-a Prospective Study

Nazi

Anisha

Ghanbarlou

2021

Int J Pharm Pharm Sci

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“…Children in the critical care unit are at risk of having their nutritional status deteriorating due to their disease or barriers to nutrient delivery ( 43 ), further worsening their prognosis ( 42 ). Appropriate nutritional interventions for UN patients can decrease their incidence of mortality, which is similarly found in the study by Sharma et al ( 33 ); the intervention group had a decreased mortality incidence as a result of appropriate nutritional interventions.…”

Section: Discussionsupporting

confidence: 69%

“…The forest plot was described as having UN cases significantly decreased mortality incidence in two studies ( 27 , 37 ), while four out of eleven studies described increased significance in mortality incidence on UN children, which was between 3 and 18 percentiles ( 24 , 28 , 30 , 33 ); for more details, refer to Figure 2A .…”

Section: Resultsmentioning

confidence: 99%

Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review

Albadi

Bookari

2022

Front. Pediatr.

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Background and aimUndernutrition (UN) may negatively impact clinical outcomes for hospitalized patients. The relationship between UN status at pediatric intensive care unit (PICU) admission and clinical outcomes is still not well-reported. This systematic meta-analysis review evaluated the impact of UN at admission to PICU on clinical outcomes, including mortality incidence, length of stay (LOS), and the need for and length of time on mechanical ventilation (MV).MethodsA search was conducted using relevant and multi-medical databases from inception until January 2022. We considered studies that examined the link between UN at PICU admission and clinical outcomes in patients aged 18 years or younger. Pooled risk difference estimates for the PICU outcomes were calculated using a random-effects model.ResultThere were a total of 10,638 patients included in 17 observational studies; 8,044 (75.61%) and 2,594 (24.38%) patients, respectively, were normal-nourished (NN) and undernourished (UN). In comparison to NN patients, UN patients had a slightly higher risk of mortality (RD = 0.02, P = 0.05), MV usage (RD = 0.05, P = 0.02), and PICU LOS (RD = 0.07, P = 0.007). While the duration of MV was significantly longer in UN than in NN (RD = 0.13, P < 0.0001). Sensitivity analysis of UN classification cohorts with a z-score < -2 or in the 5%, patetints age up to 18 years, and mixed diagnose for PICU admission demonstrated a 6-fold increase in the probability of PICU LOS in UN patients compared to NN patients (RD = 0.06, 95% CI = 0.01, 0.12). UN patients have a higher risk of MV usage RD = 0.07, 95% CI = 0.00, 0.14) in studies involving cohorts with a mixed primary diagnosis for PICU admission.ConclusionIn PICU, UN is linked to mortality incidence, longer PICU stay, MV usage, and duration on MV. The primary diagnosis for PICU admission may also influence clinical outcomes. Determining the prevalence of UN in hospitalized patients, as well as the subgroups of patients diagnosed at the time of admission, requires more research. This may help explain the relationship between nutritional status and clinical outcomes in PICU patients.

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“… 7 Sharma et al also reported pediatric intensive care units and hospital lengths of stays were higher in underweight children, and underweight children were younger when compared to normal or obese children. 23 On the other hand, a study done in hospitalized pediatric patients aged 2 to 18 years showed obese patients had 15% longer hospital stays and 19% higher hospital costs than normal weight patients, when controlled for age, sex, ethnicity, insurance type, calendar year, and primary diagnosis. 24 This U-shaped curve was also reported in mortality rate in pediatric intensive care units with respect to weight centile, and the lowest mortality rate was around 75th weight-for-age centile.…”

Section: Discussionmentioning

confidence: 99%

Impact of Weight on Severity of Hospital Course in Children Admitted With COVID-19

Tantivit,

Mulekar,

Kaulfers

et al. 2023

Global Pediatric Health

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Objective. To describe the impact of weight on length of stay (LOS) and oxygen requirement among hospitalized children with COVID-19. Methods. This is a retrospective review of 153 children admitted for COVID-19 from March 2020 to October 2021. Body mass index (BMI) percentile and weight-for-age (WFA) percentile were used to determine weight status for children ≥2 years and <2 years respectively. Results. We found 2 distinct patterns for patients <2 years and ≥2 years; The likelihood of needing oxygen and LOS ≥ 5 days was higher for children ≥2 years with BMI ≥ 85th percentile ( P = .0415 and P = .0197). Among those <2 years, mean WFA percentile decreased with increasing oxygen need ( P = .0325). There was a negative correlation between LOS and WFA percentile ( r = −.31, P = .0123). Conclusion. It is important to stratify patients’ risk according to their age, BMI and WFA percentile during hospitalization for COVID 19.

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The impact of body mass index on resource utilization and outcomes of children admitted to a pediatric intensive care unit

Cited by 7 publications

References 48 publications

Assessment of Antibiotic Usage Pattern in Patients of Pediatric Department-a Prospective Study

Assessment of Antibiotic Usage Pattern in Patients of Pediatric Department-a Prospective Study

Is Undernutrition Associated With Deterioration of Outcomes in the Pediatric Intensive Care Unit (PICU): Systematic and Meta-Analysis Review

Impact of Weight on Severity of Hospital Course in Children Admitted With COVID-19

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