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Screening for nutritional risk in hospitalized children with liver disease
Tiantian Song1, Ying Mu1, Xue Gong1
1Department of Clinical Nutrition, The 302 Military Hospital of China, Beijing, China.
Insights
Malnutrition is common in hospitalized children with liver disease, with high nutritional risk at admission. Nutritional support rates are low, despite links to longer hospital stays and increased costs.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Hepatology
Background:
- Malnutrition significantly impacts morbidity and mortality in pediatric liver disease.
- Assessing nutritional status and risk is crucial for hospitalized children with liver conditions.
Purpose of the Study:
- To determine the prevalence of malnutrition and high nutritional risk in hospitalized children with liver disease.
- To evaluate the rate of in-hospital nutritional support and its impact on outcomes.
Main Methods:
- A cohort of 2,874 children (1-17 years) with liver disease was analyzed.
- Malnutrition was screened using anthropometric measures; nutritional risk was assessed with the STRONGkids tool.
- Serum albumin, prealbumin, nutritional support rates, length of stay, and hospital costs were compared across risk groups.
Main Results:
- Overall malnutrition prevalence was 38.6%; 20.0% had high nutritional risk.
- Malnutrition was significantly higher in the high-risk group (67.9%) versus moderate-risk (31.3%).
- Children with high nutritional risk experienced longer hospital stays and higher costs, with low rates of nutritional support (8.9%).
Conclusions:
- High prevalence of malnutrition and nutritional risk exists in hospitalized children with liver disease.
- Serum albumin and prealbumin effectively differentiate nutritional risk levels.
- In-hospital nutritional support is underutilized, necessitating standardization to improve patient outcomes and reduce healthcare costs.
Background And Objectives:
Malnutrition is a major contributor to morbidity and mortality from pediatric liver disease. We investigated the prevalence of both malnutrition and high nutritional risk in hospitalized children with liver disease as well as the rate of in-hospital nutritional support.
Methods And Study Design:
A total of 2,874 hospitalized children and adolescents with liver disease aged 1 to 17 years (inclusive) were enrolled. Malnutrition was screened by anthropometric measures (height-for-age, weight-for-height, weight-for-age, and BMI- for-age z-scores). The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) was used to evaluate nutritional risk status. Nutrition markers in blood, rate of nutritional support, length of hospital stay, and hospital fees were compared among nutritional risk groups.
Results:
The overall prevalence of malnutrition was 38.6%. About 20.0% of children had high nutritional risk, and prevalence of malnutrition was markedly greater in the high nutritional risk group compared with the moderate risk group (67.9% vs 31.3%). Serum albumin and prealbumin differed significantly between high and moderate risk groups (p<0.001). Only 8.9% of children with high nutritional risk and 3.5% with moderate nutritional risk received nutrition support during hospitalization. Children with high nutritional risk had longer hospital stays and greater hospital costs (p<0.001).
Conclusions:
The prevalence of malnutrition is high in children with liver disease. High nutritional risk is also prevalent at admission. Albumin and prealbumin are sensitive markers for distinguishing nutritional risk groups. High nutritional risk prolongs length of stay and increases hospital costs. The nutritional support rate is still low and requires standardization.
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