Abdelhadi Ruba A, Bouma Sandra, Bairdain Sigrid, Wolff Jodi, Legro Amanda, Plogsted Steve, Guenter Peggi, Resnick Helaine, Slaughter-Acey Jaime C, Corkins Mark R
Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA
University of Michigan C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA.
JPEN J Parenter Enteral Nutr. 2016 Jul;40(5):623-35. doi: 10.1177/0148607116633800. Epub 2016 Mar 22.
Malnutrition is common in hospitalized patients in the United States. In 2010, 80,710 of 6,280,710 hospitalized children <17 years old had a coded diagnosis of malnutrition (CDM). This report summarizes nationally representative, person-level characteristics of hospitalized children with a CDM.
Data are from the 2010 Healthcare Cost and Utilization Project, which contains patient-level data on hospital inpatient stays. When weighted appropriately, estimates from the project represent all U.S. hospitalizations. The data set contains up to 25 ICD-9-CM diagnostic codes for each patient. Children with a CDM listed during hospitalization were identified.
In 2010, 1.3% of hospitalized patients <17 years had a CDM. Since the data include only those with a CDM, malnutrition's true prevalence may be underrepresented. Length of stay among children with a CDM was almost 2.5 times longer than those without a CDM. Hospital costs for children with a CDM were >3 times higher than those without a CDM. Hospitalized children with a CDM were less likely to have routine discharge and almost 3.5 times more likely to require postdischarge home care. Children with a CDM were more likely to have multiple comorbidities.
Hospitalized children with a CDM are associated with more comorbidities, longer hospital stay, and higher healthcare costs than those without this diagnosis. These undernourished children may utilize more healthcare resources in the hospital and community. Clinicians and policymakers should factor this into healthcare resource utilization planning. Recognizing and accurately coding malnutrition in hospitalized children may reveal the true prevalence of malnutrition.
营养不良在美国住院患者中很常见。2010年，在6280710名17岁以下住院儿童中，有80710人被编码诊断为营养不良（CDM）。本报告总结了患有CDM的住院儿童具有全国代表性的个人层面特征。
数据来自2010年医疗成本和利用项目，该项目包含医院住院患者的个人层面数据。经过适当加权后，该项目的估计值代表了美国所有的住院情况。数据集为每位患者最多包含25个国际疾病分类第九版临床修正版（ICD-9-CM）诊断代码。确定了住院期间列出患有CDM的儿童。
2010年，17岁以下住院患者中有1.3%患有CDM。由于数据仅包括那些患有CDM的患者，营养不良的真实患病率可能被低估。患有CDM的儿童的住院时间几乎是没有CDM的儿童的2.5倍。患有CDM的儿童的住院费用比没有CDM的儿童高出3倍多。患有CDM的住院儿童进行常规出院的可能性较小，而需要出院后家庭护理的可能性几乎是其3.5倍。患有CDM的儿童更有可能患有多种合并症。
与没有这种诊断的儿童相比，患有CDM的住院儿童合并症更多、住院时间更长、医疗费用更高。这些营养不良的儿童可能在医院和社区中使用更多的医疗资源。临床医生和政策制定者应将此因素纳入医疗资源利用规划中。识别并准确编码住院儿童的营养不良情况可能会揭示营养不良的真实患病率。
