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

• Published in: Journal of human nutrition and dietetics 2023-08, Vol.36 (4), p.1359-1367
• Main Authors: Viana Alves, Marília de Fátima, Cruvel, Juliana Moreira da Silva, Coutinho, Marluce Alves, Sousa, Maria Milena Bezerra, Barbosa, Elza Cristina Batista, Pires, Bruna Renata Fernandes
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Body mass; Body mass index; Body size; Body weight loss; Child; Child, Preschool; Children; hospitalisation; Hospitalization; Hospitals; Humans; Length of Stay; Malnutrition; Malnutrition - epidemiology; Medical records; Neuropathy; Nutritional Status; paediatrics; Patients; Pediatrics; Regression analysis; Retrospective Studies; Teenagers; Tertiary Care Centers; Undernutrition; Weight Loss
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/jhn.13106

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. Key points Hospital‐acquired malnutrition comprises a further deterioration of the patient's nutritional status in relation to their nutritional status at admission. The present study was conducted with 473 children and adolescents admitted to a tertiary care hospital. In the study, during hospitalisation, it was observed that a significant percentage of patients had a weight loss of > 2% and one‐third had hospital‐acquired malnutrition. Gastroenteropathies, neuropathies and malnutrition on admission were significantly associated with hospital‐acquired malnutrition.