Jiménez GR, Santana PS

Language: Spanish
References: 21
Page: 236-247
PDF size: 260.91 Kb.

ABSTRACT

Rationale: There is an interest in getting to know the state of undernutrition in pediatric hospitals. Material and method: A crosssectional survey was conducted at the Pediatric Teaching Hospital “Juan Manuel Márquez” (La Habana, Cuba) aimed to estimate the current frequency of hospital pediatric undernutrition. Height and Weight values were obtained from 157 children (Boys: 53.5%; Ages › 2.5 years: 61.8%) admitted to the institution between January-March of 2008. BMI Body Mass Index was estimated from Height and Weight values. Values of anthropometric measures were expressed as standard deviation units from the gravity center of corresponding Cuban Tables for Sex and Age. PNRS Pediatric Nutritional Risk Score survey was administered in parallel in order to estimate the undernutrition risk of the child given the main health problem. Results: Hospital undernutrition frequency was of 24.2%, disaggregated as follows: Height for Age z-score ‹ -1.0 s: 7.6%; Weight for Age z-score ‹ -1.0 s: 10.2%; and BMI for Age z-score ‹ -1.0 s: 19.7%; respectively. Ten point two percent of surveyed children had 2 or more of the survey anthropometric measures simultaneously affected. Pediatric hospital undernutrition concentrated among orthopedic diseases (50.0%); gastrointestinal illnesses (46.7%); urological problems (28.6%); and respiratory diseases (22.5%). Nutrition (58.8%); Critical care (44.4%); Orthopedics (33.3%); Neurology (26.7%); Nephrology (22.2%); and Neumology (21.9%) services were those most affected by pediatric hospital undernutrition. Undernutrition rate was of 52.0% among children having up to 24 hours of hospital stay, but lower than 20.0% for those with 2–30 days of admission. Although only 15.9% of surveyed children accumulated more than 30 days of hospitalization, 32.0% of them were malnourished at the time of the survey. Eighty two point two percent of surveyed children showed moderated to high risk of malnutrition because of the main health problem. Malnutrition risk was independent from anthropometric status and length of stay. Twelve point seven percent of surveyed children had Weight values › +2.0 s of those expected for Sex and Age. Conclusions: Elevated undernutrition frequency observed during the first 24 hours of admission implies that the institution is inheriting nutritional disorders overlooked in the surveyed child’s dwelling community. Children exhibiting polar nutritional phenotypes on both sides of the nutritional spectrum might coexist in a hospital environment. Understanding of interactions that might exist between nutritional state, underlying disease, and length of stay should be translated into novel intervention measures aimed to ameliorate disease-related malnutrition in a pediatric hospital.

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