Saengnipanthkul Suchaorn, Apiraksakorn Amnuayporn, Densupsoontorn Narumon, Chongviriyaphan Nalinee
Division of Nutrition, Department of Pediatrics, Faculty of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand. Email:
Department of Pediatrics, Khon Kaen Hospital, Khon Kaen, Thailand.
Asia Pac J Clin Nutr. 2023;32(1):85-92. doi: 10.6133/apjcn.202303_32(1).0013.
Malnutrition is a major public health concern that increases morbidity and mortality in hospitalized patients, particularly those in developing countries. This study aimed to investigate its prevalence, risk factors, and impact on clinical outcomes in hospitalized children and adolescents.
We conducted a prospective cohort study in patients aged 1 month to 18 years who were admitted to four tertiary care hospitals between December 2018 and May 2019. We collected demographic data, clinical information, and nutritional assessment within 48 hours of admission.
A total of 816 patients with 883 admissions were included. Their median age was 5.3 years (interquartile range 9.3). Most patients (88.9%) were admitted with mild medical conditions (e.g., minor infection) or noninvasive procedures. The prevalence of overall malnutrition was 44.5%, while that of acute and chronic malnutrition was 14.3% and 23.6%, respectively. Malnutrition was significantly associated with age ≤2 years, preexisting diseases (cerebral palsy, chronic cardiac diseases, and bronchopulmonary dysplasia), and muscle wasting. Addi-tional risk factors for chronic malnutrition included biliary atresia, intestinal malabsorption, chronic kidney disease, as well as inability to eat and decreased food intake for >7 days. Malnourished patients had a significantly longer hospitalization duration, higher hospital cost, and nosocomial infection rates than did well-nourished patients.
Patients with chronic medical conditions on admission are at risk for malnutrition. Therefore, determination of admission nutritional status must be assessed, and its management are requisites for improved inpatient outcomes.
营养不良是一个重大的公共卫生问题，会增加住院患者尤其是发展中国家住院患者的发病率和死亡率。本研究旨在调查住院儿童和青少年中营养不良的患病率、危险因素及其对临床结局的影响。
我们对2018年12月至2019年5月期间入住四家三级医疗机构的1个月至18岁患者进行了一项前瞻性队列研究。我们在入院48小时内收集了人口统计学数据、临床信息和营养评估资料。
共纳入816例患者的883次住院病例。他们的中位年龄为5.3岁（四分位间距为9.3）。大多数患者（88.9%）因轻度疾病（如轻微感染）或非侵入性手术入院。总体营养不良的患病率为44.5%，急性和慢性营养不良的患病率分别为14.3%和23.6%。营养不良与年龄≤2岁、既往疾病（脑瘫、慢性心脏病和支气管肺发育不良）以及肌肉萎缩显著相关。慢性营养不良的其他危险因素包括胆道闭锁、肠道吸收不良、慢性肾病以及不能进食和食物摄入量减少超过7天。营养不良的患者住院时间明显更长，住院费用更高，医院感染率也高于营养良好的患者。
入院时患有慢性疾病的患者有营养不良的风险。因此，必须评估入院时的营养状况，对其进行管理是改善住院患者结局的必要条件。
