Child and Adolescent Health Care Unit, University Hospital of the Federal University of Maranhão, Maranhão, Brazil.
Clinical Nutrition Unit, University Hospital of the Federal University of Maranhão, Maranhão, Brazil.
J Hum Nutr Diet. 2023 Aug;36(4):1359-1367. doi: 10.1111/jhn.13106. Epub 2022 Nov 3.
The present study aimed to verify the proportion and factors associated with hospital-acquired malnutrition in the paediatric unit of a tertiary care hospital.
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.
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.
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.
本研究旨在验证三级保健医院儿科发生医院获得性营养不良的比例和相关因素。
本研究为巴西马拉尼昂州一家三级保健医院的回顾性研究。从病历中收集儿童和青少年的人口统计学和临床数据，并从世界卫生组织（WHO）Anthro®和 WHO Anthro Plus®应用程序中获取体重、身高和人体测量指标的 z 分数数据。入院时体重与身高 z 分数（<5 岁）和体质指数（BMI）/年龄 z 分数（≥5 岁）< -2 SD 的患者被认为存在营养不良。入院时和出院时 BMI 年龄 z 分数（BMIZ）之间 z 分数下降>0.25 SD 的患者被归类为发生医院获得性营养不良。还评估了体重减轻情况，当入院时和出院前的体重之间的差异>2%时，则认为体重减轻显著。采用 logistic 回归分析来验证与医院获得性营养不良相关的因素。
中位年龄为 4.7 岁，住院时间为 21 天；26.8%的患者在住院期间体重显著减轻，且有更大比例的患者发生医院获得性营养不良（34.9%）。入院时的胃肠道疾病、神经病变和营养不良与医院获得性营养不良显著相关。
医院获得性营养不良在儿科患者中仍然是一个问题。因此，当旨在避免儿科患者在住院期间营养状况恶化时，从入院时开始提供充足的营养支持至关重要。
