[Influence of nutritional status on clinical outcomes in hospitalised children]

Abstract

Introduction: Paediatric malnutrition during hospital admission is a prevalent comorbidity, which it is estimated around 31.4% in our environment, and could influence the clinical outcomes of paediatric patients.

Objective: The aim of this study was to describe the malnutrition risk in hospitalised children using STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics), and to study its relationship with clinical outcomes.

Methods: A single-centre, analytical and prospective study was conducted on children aged 1 month to 15 years hospitalised in a tertiary hospital between October and December 2017. An analysis was made of the clinical data and anthropometric measurements (weight, height, Waterlow weight classification). Patients were classified according to STAMP, which is a validated screening tool used to classify the risk of paediatric malnutrition during hospital admission. Multivariate statistical analysis was used to identify predictive variables of illness severity.

Results: An analysis was made on a total of 200 patients (55% male), with a median age of 15.8 months (IQR 2.5-42.8), and a median length of stay of 3 days (IQR 1-18 days). Almost half (48.3%) of them had high risk of malnutrition at admission (STAMP ≥4), and 48.2% showed medium risk (STAMP 2-3). A higher STAMP score was associated with longer length of hospital stay (P<.01) and greater severity (P<.01). Multivariable analysis showed that STAMP could be a predictor of illness severity (OR 1.48, 95% CI: 1.18-1.86, P<.01).

Conclusions: Nearly 50% of hospitalised children have a high risk of malnutrition at admission according to the STAMP screening tool. Risk of malnutrition at admission measured according to STAMP nutritional screening was associated with a longer length of stay and greater severity of illness. It is important to evaluate the risk of malnutrition as this could be related to illness severity.

Keywords: Cribado nutricional; Desnutrición hospitalaria; Estado nutricional; Hospital admission; Hospital malnutrition; Hospitalización pediátrica; Malnutrición; Malnutrition; Nutritional assessment; Nutritional screening; Nutritional status; Valoración nutricional.