Hospital-acquired malnutrition in children with mild clinical conditions

Campanozzi, Angelo; Russo, Massimo; Catucci, Alessandra; Rutigliano, Irene; Canestrino, Gennaro; Giardino, Ida; Romondia, Arturo; Pettoello-Mantovani, Massimo

doi:10.1016/j.nut.2008.11.026

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Volume 25, Issue 5 , Pages 540-547, May 2009

Hospital-acquired malnutrition in children with mild clinical conditions

Angelo Campanozzi, M.D.
- Department of Medical Sciences, Pediatrics, University of Foggia, Foggia, Italy
- Corresponding author. Tel./fax: +39-0881-733718
Massimo Russo, Ph.D.
- Institute of Statistics, University of Foggia, Foggia, Italy
Alessandra Catucci, M.D.
- Department of Medical Sciences, Pediatrics, University of Foggia, Foggia, Italy
Irene Rutigliano, M.D.
- Department of Medical Sciences, Pediatrics, University of Foggia, Foggia, Italy
Gennaro Canestrino, M.D.
- Department of Medical Sciences, Pediatrics, University of Foggia, Foggia, Italy
Ida Giardino, M.D.
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
Arturo Romondia, M.D.
- Pediatric Unit, Public City Hospital, OORR, Foggia, Italy
Massimo Pettoello-Mantovani, M.D., Ph.D.
- Department of Medical Sciences, Pediatrics, University of Foggia, Foggia, Italy
- World Health Policy Forum (WHPF), Giessen, Germany

Received 6 July 2008; accepted 19 November 2008. published online 23 February 2009.

Abstract

Objective

Little is known about the incidence and risk factors of hospital-acquired malnutrition in children with mild illness (grade 1 clinical conditions) and its timing of occurrence. The aim of this study was to recognize any early stage of denutrition and possible risk factors leading to nutritional deterioration in children hospitalized due to mild clinical conditions.

Methods

Four hundred ninety-six children (age 1–192 mo) with mild clinical conditions were studied. Weight and height were measured. Weight was assessed daily and body mass index (BMI) Z-score was calculated for all patients.

Results

Children with a BMI Z-score <−2 SD on admission showed a mean BMI decrease at the end of their hospital stay, which was significantly higher than in children who showed a better nutritional condition at admission. Risk factors for hospital-acquired malnutrition were an age <24 mo, a duration of hospital stay >5 d, fever, and night-time abdominal pain.

Conclusion

Hospital stay has an impact on the nutritional status of children affected by mild clinical conditions. Children already malnourished on admission were found to be at risk for further nutritional deterioration during their hospital stay; and in all groups of children identified by their BMI Z-score at admission, nutritional status declined progressively.

Keywords: Children, Hospital malnutrition, Body mass index