Hendricks K M, Duggan C, Gallagher L, Carlin A C, Richardson D S, Collier S B, Simpson W, Lo C
Simmons College, Boston, Mass, USA.
Arch Pediatr Adolesc Med. 1995 Oct;149(10):1118-22. doi: 10.1001/archpedi.1995.02170230072010.
To document the current prevalence of protein-energy malnutrition compared with that reported from the same institution in 1976.
All inpatients of this tertiary-care facility were assessed by anthropometric, laboratory, and clinical nutrition assessment methods in a 1-day cross-sectional survey. The comparison study from 1976 was also a 1-day cross-sectional survey.
A tertiary-care facility in Boston, Mass.
The entire inpatient population was assessed on a single weekday in September 1992.
Prevalence of acute and chronic malnutrition as judged by anthropometric and laboratory data. Data on demographics, admission classification, underlying disease, route of nutrition, and global nutritional status were also assessed.
The prevalence of acute protein-energy malnutrition (weight for height) based on the Waterlow criteria was as follows: severe, 1.3%; moderate, 5.8%; mild, 17.4%; and none, 75.5%. The prevalence of chronic protein-energy malnutrition (height for age) was as follows: severe, 5.1%; moderate, 7.7%; mild, 14.5%; and none, 72.8%. Although the prevalence of acute and chronic protein-energy malnutrition was significantly less in 1992 than in 1976 (P = .03 and P < .001, respectively), the numbers are still alarmingly high. Children younger than 2 years and older than 18 years and those with chronic medical conditions had a higher prevalence of protein-energy malnutrition. Twenty-four percent of patients had a serum albumin level less than 30 g/L, 34.8% had a total lymphocyte count less than 1.5 x 10(9)/L, and 24.9% had a hemoglobin concentration less than 105 g/L. One fourth of all patients were obese (> 120% weight for height), with the greatest prevalence in children aged 2 to 18 years.
Acute and chronic protein-energy malnutrition remains common in hospitalized pediatric patients in the United States. Important risk factors may be underlying chronic disease, periods of normally rapid growth, and recognized need for nutrition intervention.
记录当前蛋白质 - 能量营养不良的患病率，并与1976年同一机构报告的患病率进行比较。
在一项为期1天的横断面调查中，采用人体测量、实验室和临床营养评估方法对这家三级医疗设施的所有住院患者进行评估。1976年的比较研究也是一项为期1天的横断面调查。
马萨诸塞州波士顿的一家三级医疗设施。
1992年9月的一个工作日对全体住院患者进行了评估。
根据人体测量和实验室数据判断的急性和慢性营养不良的患病率。还评估了人口统计学、入院分类、基础疾病、营养途径和整体营养状况的数据。
根据沃特洛标准，急性蛋白质 - 能量营养不良（身高别体重）的患病率如下：重度，1.3%；中度，5.8%；轻度，17.4%；无营养不良，75.5%。慢性蛋白质 - 能量营养不良（年龄别身高）的患病率如下：重度，5.1%；中度，7.7%；轻度，14.5%；无营养不良，72.8%。尽管1992年急性和慢性蛋白质 - 能量营养不良的患病率显著低于1976年（分别为P = 0.03和P < 0.001），但这一数字仍然高得惊人。2岁以下和18岁以上的儿童以及患有慢性疾病的儿童蛋白质 - 能量营养不良的患病率更高。24%的患者血清白蛋白水平低于30 g/L，34.8%的患者总淋巴细胞计数低于1.5×10⁹/L，24.9%的患者血红蛋白浓度低于105 g/L。所有患者中有四分之一肥胖（身高体重比>120%），2至18岁儿童中患病率最高。
在美国住院的儿科患者中，急性和慢性蛋白质 - 能量营养不良仍然很常见。重要的危险因素可能是潜在的慢性疾病、正常快速生长阶段以及公认的营养干预需求。
