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[Evolution of nutritional status in hospitalized children]
Haroldo S Ferreira1, Adijane O S França
1Saúde Pública, Universidade Federal de Alagoas, Maceió, AL. haroldo@fapeal.br
Insights
Children admitted to the hospital often have poor nutritional status, with high rates of protein-energy malnutrition (PEM). Hospitalization did not improve their weight-for-age Z scores, indicating a persistent nutritional deficit.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Context:
- High prevalence of malnutrition in hospitalized children.
- Limited data on nutritional status evolution during hospitalization.
Purpose:
- To assess changes in nutritional status (weight-for-age Z scores) in children during hospitalization.
- To identify factors associated with nutritional status changes.
Summary:
- A retrospective study of 52 children (0-10 years) hospitalized for over 10 days.
- Nutritional status was assessed at admission (T1) and discharge (T2) using weight-for-age Z scores.
- High rates of protein-energy malnutrition (PEM) were observed (71.2% at T1, 69.2% at T2), with underdiagnosis.
- Longer hospital stays correlated with greater weight deficits, suggesting hospitalization did not improve nutritional status.
Impact:
- Highlights the critical issue of malnutrition in hospitalized pediatric populations.
- Suggests a need for improved nutritional monitoring and intervention strategies within hospitals.
- Underscores the potential negative impact of prolonged hospitalization on children's nutritional well-being.
Objective:
To assess the evolution of nutritional status in children admitted to the Teaching Hospital of Universidade Federal de Alagoas.
Methods:
A retrospective study was performed on 52 children (0-10 yrs) whose length of hospital stay exceeded 10 days (from February to July/2001). We compared their nutritional status, expressed in terms of Z score of the weight-for-age ratio at the beginning (T1) and at the end of the hospitalization period (T2).
Results:
The predominant age range (44.2%) was less than 1 year (median=1.4 yrs). The hospitalization period varied from 10 to 77 days (median=20 days). Although the prevalence rates of protein-energy malnutrition (PEM) in T1 and T2 were, respectively, 71.2% and 69.2%, only 15.4% had this diagnosis on the medical records. These children diagnosed with protein-energy malnutrition presented extreme wasting and greater length of hospital stay than the others (PEM, n=8: -4.38 +/- 2.1, T=30 +/- 4.5; undiagnosed PEM, n=13: -3.13 +/- 0.9, T=23 +/- 18; other conditions, n=31: -0.63 +/- 1.1, T=21 +/- 13). Among the 52 children analyzed, only 29 showed positive weight variation. However, the average magnitude of negative Z values was higher than that of positive values: -0.56 and 0.50. Children who remained in hospital for a longer period of time showed larger weight deficits, indicating that hospitalization did not contribute towards the improvement of their initial nutritional status.
Conclusion:
The prevalence of weight-for-age deficit among children at hospital admission was very high. This situation remained unchanged at hospital discharge.
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