Hospital-acquired undernutrition and associated factors in children and adolescents admitted to a tertiary care hospital

J Hum Nutr Diet. 2023 Aug;36(4):1359-1367. doi: 10.1111/jhn.13106. Epub 2022 Nov 3.

Abstract

Background: The present study aimed to verify the proportion and factors associated with hospital-acquired malnutrition in the paediatric unit of a tertiary care hospital.

Methods: A retrospective study was carried out in a tertiary care hospital in the state of Maranhão, Brazil. Demographic and clinical data on children and adolescents were collected from medical records and the data regarding weight, height and z-scores of anthropometric indicators were obtained from the World Health Organization (WHO) Anthro® and WHO Anthro Plus® applications. Those with weight-for-height z-score (< 5 years) and a body mass index (BMI)/age z-score (≥ 5 years) < -2 SD at admission were considered to be malnourished. Patients who presented a decrease of > 0.25 SD between the z-score of BMI-for-age (BMIZ) at admission and at discharge were classified as having hospital-acquired malnutrition. Weight loss was also evaluated and was considered significant when it was > 2% between the weight measured at admission and the one before discharge. Logistic regression analysis was performed to verify the factors associated with hospital-acquired malnutrition.

Results: The median age was 4.7 years and the length of stay was 21 days; 26.8% of patients had significant weight loss during hospitalisation and a greater proportion had hospital-acquired malnutrition (34.9%). Gastroenteropathies, neuropathies and malnutrition on admission were significantly associated with hospital-acquired malnutrition.

Conclusions: The occurrence of hospital-acquired malnutrition is still a problem in paediatric patients. Thus, providing adequate nutritional support from admission is essential when aiming to avoid deterioration of the nutritional status of paediatric patients during hospitalisation.

Keywords: hospitalisation; malnutrition; paediatrics; undernutrition.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Hospitalization
  • Humans
  • Length of Stay
  • Malnutrition* / epidemiology
  • Nutritional Status
  • Retrospective Studies
  • Tertiary Care Centers
  • Weight Loss