Hospital-acquired undernutrition and associated factors in children and adolescents admitted to a tertiary care hospital

Background The present study aimed to verify the proportion and factors associated with hospital-acquired malnutrition in the paediatric unit of a tertiary care hospital. Methods A retrospective study was carried out in a tertiary care hospital in the state of Maranhao, Brazil. Demographic and clinical data on children and adolescents were collected from medical records and the data regarding weight, height and z-scores of anthropometric indicators were obtained from the World Health Organization (WHO) Anthro (R) and WHO Anthro Plus (R) applications. Those with weight-for-height z-score (< 5 years) and a body mass index (BMI)/age z-score (>= 5 years) < -2 SD at admission were considered to be malnourished. Patients who presented a decrease of > 0.25 SD between the z-score of BMI-for-age (BMIZ) at admission and at discharge were classified as having hospital-acquired malnutrition. Weight loss was also evaluated and was considered significant when it was > 2% between the weight measured at admission and the one before discharge. Logistic regression analysis was performed to verify the factors associated with hospital-acquired malnutrition. Results The median age was 4.7 years and the length of stay was 21 days; 26.8% of patients had significant weight loss during hospitalisation and a greater proportion had hospital-acquired malnutrition (34.9%). Gastroenteropathies, neuropathies and malnutrition on admission were significantly associated with hospital-acquired malnutrition. Conclusions The occurrence of hospital-acquired malnutrition is still a problem in paediatric patients. Thus, providing adequate nutritional support from admission is essential when aiming to avoid deterioration of the nutritional status of paediatric patients during hospitalisation.

Automated summary

This study aimed to verify the proportion and factors associated with hospital-acquired malnutrition in the paediatric unit of a tertiary care hospital in Maranhao, Brazil. The results showed that hospital-acquired malnutrition is still a problem in paediatric patients, and is significantly associated with gastroenteropathies, neuropathies, and malnutrition on admission.