Nutritional Status, Nutritional Support and Course of Disease in Pediatric Patients Hospitalized for Severe Acute Diseases: TL014

Abstract

Introduction: Pediatric patients hospitalized due to severe acute diseases are at risk of protein energy malnutrition (PEM) and consequently have a greater risk of complications and prolonged stays.Objectives: To evaluate the magnitude of PEM, metabolic disorders related to PEM and the effect of nutritional support on the course of disease in children hospitalized due to an acute severe disease.Subjects and Methods: We studied 123 children (1-188 months) admitted consecutively for a severe disease at Hospital San Borja Arriarán, in Santiago, Chile. The nutritional assessment included anthropometric (height and weight) and biochemical measurements (serum albumin and blood count) on admission and on the 5th day. Food consumption was evaluated by weighing foods and severity of disease was measured by PRISM. Therapies, complications of disease and days before discharge, were also recorded.Results: The mean stay was 3.0 ± 2.6 days (1-20) and PRISM was 6.5 ± 4.2 (0-20). Nutritional status revealed: 46% with PEM (28.5% acute, 17.1% chronic), 10% with albumin < 3.5 g/dL, 11% overweight and 33% normal. On 5th day, 35% of children decreased weight/height ratio, 55% improved it and 10% did not show any change. Children were fed with oral feedings (49%) or enteral nutrition (20%). Twenty percent received their energy requirements for disease. Those with PEM presented a greater risk of complications (RR=1.50;1.03-2.17) and a greater severity of disease (RR=1.51;1.03-2.20) than those without malnutrition. Patients with decreased serum albumin had a greater risk of prolonged stay at hospital (RR=1.50; 1.12- 2.01).Conclusions: Children with acute or chronic protein energy malnutrion present a worst course of disease, with more days of hospitalizat ion and a greater risk for complications than those without malnutrition. The children repeatedly did not receive their energy requirements adapted to disease