Indicators of Pediatric Malnutrition in a Tertiary Care Hospital

This study was conducted to determine the prevalence of malnutrition at a Canadian children's hospital based on medical records and to identify gaps in current practices and rates/reasons for dietitian consult.

A retrospective chart audit of patients admitted during a winter season was completed. Patients with length of stay <4 days were excluded, as were those with fluid retention diseases. Outcome variables included anthropometrics, diet order, rates and reasons for dietitian consult, and biochemical data.

Of the 83 charts reviewed (mean ± SD age 7.3 ± 5.6 years of age), weights were recorded less frequently than recommended (45% of patients ≤2 years of age and 85% of patients >2 years of age met or exceeded recommendations). Twenty-nine (36%) patients were identified at potential increased nutrition risk for overweight, 10 (12%) for underweight, and 31 (38%) patients had nutrition-related chart notes. Only 23 patients (28%) received a dietitian consult and, of those, 21 had a nutrition related chart note. Consultation occurred an average 5.4 ± 4.96 days after admission.

These data emphasize the need for development of standardized screening and assessment tools to better identify pediatric patients at risk for malnutrition and to improve access to optimal nutrition care.