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Clin Nutr. 2015 Feb;34(1):53-9. doi: 10.1016/j.clnu.2014.01.003. Epub 2014 Jan 11.

Disease associated malnutrition correlates with length of hospital stay in children.

Author information

1
Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.
2
Clinical Nutrition Lab "Christos Mantzoros", Department of Nutrition and Dietetics, Alexander Technological Education Institute of Thessaloniki, Greece.
3
Department of Pediatric Emergency, Fondazione IRCCS Ca' Granada Ospedale Maggiore Policlinico, Milan, Italy.
4
Department of Paediatric Gastroenterology, Hepatology and Nutrition, National Health Service Greater Glasgow and Clyde, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK.
5
Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, Royal Hospital for Sick Children, University of Glasgow, Glasgow G3 8SJ, UK.
6
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children's Hospital, Pediatric Clinical Investigation Centre, Inserm U995, Faculty of Medicine, University Lille 2, Lille, France.
7
Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
8
Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
9
Beatrix Children's Hospital, University Hospital Groningen, Groningen, The Netherlands.
10
Children's Hospital Zagreb University Medical School, Croatia.
11
Department of Paediatrics and Nutrition, The Children's Memorial Health Institute, Warsaw, Poland.
12
Pediatric Clinic II, Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granada Ospedale Maggiore Policlinico, Milan, Italy.
13
The Medical University of Warsaw, Department of Paediatrics, Poland.
14
Childrens Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
15
Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany. Electronic address: office.koletzko@med.uni-muenchen.de.

Abstract

BACKGROUND & AIMS:

Previous studies reported a wide range of estimated malnutrition prevalence (6-30%) in paediatric inpatients based on various anthropometric criteria. We performed anthropometry in hospitalised children and assessed the relationship between malnutrition and length of hospital stay (LOS) and complication rates.

METHODS:

In a prospective multi-centre European study, 2567 patients aged 1 month to 18 years were assessed in 14 centres in 12 countries by standardised anthropometry within the first 24 h after admission. Body mass index (BMI) and height/length <-2 standard deviation scores (SDS, WHO reference) were related to LOS (primary outcome), frequency of gastrointestinal (diarrhoea and vomiting) and infectious complications (antibiotic use), weight change during stay (secondary outcomes) and quality of life.

RESULTS:

A BMI <-2 SDS was present in 7.0% of the patients at hospital admission (range 4.0-9.3% across countries) with a higher prevalence in infants (10.8%) and toddlers aged 1-2 years (8.3%). A BMI <-2 to ≥-3 SDS (moderate malnutrition) and a BMI <-3 SDS (severe malnutrition) was associated with a 1.3 (CI95: 1.01, 1.55) and 1.6 (CI95: 1.27, 2.10) days longer LOS, respectively (p = 0.04 and p < 0.001). Reduced BMI <-2 SDS was also associated to lower quality of life, and more frequent occurrence of diarrhoea (22% vs 12%, p < 0.001) and vomiting (26% vs 14%, p < 0.001).

CONCLUSION:

Disease associated malnutrition in hospitalised children in Europe is common and is associated with significantly prolonged LOS and increased complications, with possible major cost implications, and reduced quality of life. This study was registered at clinicaltrials.gov as NCT01132742.

KEYWORDS:

Anthropometry; Hospitalized children; Length of hospital stay; Malnutrition; Short stature; Under-nutrition

PMID:
24461472
DOI:
10.1016/j.clnu.2014.01.003
[Indexed for MEDLINE]
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