Comorbid Diseases Is a Predictor Length of Stay in Children with Severe Acute Malnutrition

Abstract

Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in children in developing countries. Patient with SAM mostly hospitalized with comorbidity that reduce the time of recovery and longer the length of stay (LOS). The aim of this study is to determine the association between comorbid with longer LOS among children with SAM. This was a retrospective cohort study from 2017-2018 on children with SAM conducted in the pediatric care ward of Sanglah Denpasar General Hospital. Inclusion criteria was children aged 1 months to 18 years diagnosed with SAM and had complete data at the start of admission. Exclusion criteria was patient discharged against medical advice. 134 children with SAM were included and analyzed with appropriate statistical analysis. The median of LOS was 18 days, comorbid at admission found were infection (31.3%), non-infection (56.0%), both infection and non-infection (12.7%). HIV found as the most comorbid in SAM patient (21.3%) followed by malignancy (17.3%), congenital heart disease (14%), and pneumonia (12.7%). Multivariate analysis found that comorbid was a risk factor for longer LOS in hospitalized SAM patients. Comorbid increases the LOS by 3.23 times (95% CI 1.563-6.709) p value 0.002. Bivariate analysis found that infection as comorbid increase the LOS by 1.72 times (95% CI 1.171-2.524) p value 0.011. Conclusion that comorbid at admission was associated with longer LOS in hospitalized patient with SAM.