The Effect of Nutritional Status on Outcome of Hospitalization in Paediatric Liver Disease Patients

J Clin Diagn Res. 2016 Dec;10(12):SC01-SC05. doi: 10.7860/JCDR/2016/21606.8956. Epub 2016 Dec 1.

Abstract

Introduction: Liver is an important organ for metabolism. It has a major role in integrating the various biochemical pathways of metabolism. Thus, children with chronic liver disease are at high risk for developing undernutrition, with important prognostic implications.

Aim: To evaluate the nutritional status of hospitalized paediatric liver disease patients and its effect on outcome.

Materials and methods: We prospectively analysed the nutritional status of 59 consecutive patients during their first 24 hours of admission, at the Hepatology Unit, using the following indices: weight/age, height/age, weight/height, Body Mass Index (BMI), arm circumference and triceps skinfold, subcapular skinfold, and mid upper arm circumference.

Results: According to the measurements: 35.6% were underweight, 49% were stunted, 10% were wasted by weight for length/height percentile and 5% were wasted by body mass index, 49% had percentage of ideal body weight below normal, 27% had head circumference below 3rd percentile, 59.4% had triceps skinfold thickness below 5th percentile, 66% had subscapular skinfold thickness below 5th percentile; 56% had arm circumference below 5th percentile. There was no correlation between these growth parameters and mortality. However, we found a positive correlation between decreased triceps skinfold thickness and prolonged hospital stay. Malnourished patients, according to triceps skinfold thickness, were significantly younger and they were the ones who suffered from cholestatic disorders of infancy.

Conclusion: Only triceps skinfold thickness was found to be a useful predictor for a prolonged hospital stay. Serial measurements may be more effective.

Keywords: Hospitalized children with liver disease; Nutritional assessment; Skin fold thickness.