P1181 RISK FACTORS AND OUTCOME OF HOSPITAL ACQUIRED MALNUTRITION IN CHILDREN

Abstract

Introduction: Data from literature show that a large part of adult in-patients become nutritionally compromised in the course of their hospitalization and that hospital acquired malnutrition is associated with increased risk of adverse clinical events. However, little is known about the incidence and risk factors of hospital related undernutrition in children, its “timing” of occurrence and impact on hospital stay (HS). Our aim was to evaluate nutritional status in children admitted to a general medical pediatric ward and during their HS, possible risk factors leading to nutritional deterioration and its relationship with the duration of HS. Methods: 363 children (205 boys; age: 1–198 months; median: 23 months) were enrolled in the study. They were consecutively admitted to our general medical pediatric ward. Weight and height were measured as part of the routine admission procedure. Weight was measured daily in the same conditions and BMI was consequently calculated. Data recorded and analyzed in the study included: diagnosis at admission, symptoms at admission and during HS, food intake. Results: 351 pts were admitted for acute illness and 12 pts for relapse of a chronic disease. During HS, based on their actual nutritional status and according to multivariate statistical analysis (Classification Trees and Cox Regression - SPSS), pts were divided in 2 groups: A) 106 children (29,2%) presenting a BMI reduction (−3,1±1,9%) and B) 257 children (70,8%) with a stable or increased BMI (0,9±1,5%). According to Segmentation technique (Answer tree - SPSS), Risk Factors for hospital acquired malnutrition were: age > 10 months (p<0,05); 72 hours-diarrhoea (p<0,001); 72 hours-fever (p<0,05). Group A and Group B showed significant differences in the percentage of individuals presenting early (first 72 h) Nutritional Deterioration (eND) and in the impact of nutritional status on the duration of HS:Table 1Conclusion: hospital malnutrition was frequently observed in our in-patients and it was an early onset event in a large part of the population evaluated, as it became evident during the first three days of hospital stay. Our results suggest that BMI decrease is by its self a risk factor for longer hospital stay. An assessment of nutritional risk should be an important part of routine admission procedure especially in children older than 10 months and/or with an history of 3 days long fever or diarrhoea.