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Malnutrition in Paediatrics: Stationary Screening & Follow-up
Dorothea Werner1,2, Klaus-Peter Zimmer1, Gunter P Eckert2
1Department for General Paediatrics & Neonatology, University Hospital Giessen, Giessen, Germany.
Insights
Malnutrition is prevalent in pediatric hospital patients, with many losing weight during and after their stay. Early diagnosis and treatment are crucial for better patient outcomes and healthcare system efficiency.
Area of Science:
- Pediatric Nutrition
- Clinical Malnutrition Research
- Hospital Patient Care
Background:
- Malnutrition poses significant risks to pediatric patients.
- Assessing malnutrition prevalence and its trajectory in hospitalized children is vital.
- Tertiary care settings often manage complex pediatric cases.
Purpose of the Study:
- To determine the prevalence of malnutrition in a general pediatric ward.
- To track malnutrition status and weight changes during hospitalization and for 4 months post-discharge.
- To evaluate the effectiveness of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP).
Main Methods:
- Utilized anthropometric measurements, nutrition interviews, and the STAMP tool.
- Calculated various z-scores (HfAz, WfAz, WfHz, BMIz, MUACz) using R Studio and specific packages.
- Followed 68 pediatric patients for up to 4 months, with examinations at admission, during stay, and post-discharge.
Main Results:
- 39.71% of patients were malnourished on admission, with rates of 36.00% and 45.90% at subsequent examinations.
- 68% of inpatients experienced weight loss during their hospital stay.
- A substantial proportion of patients (35.29%) lost over 3% of their initial weight.
Conclusions:
- A significant percentage of pediatric inpatients are malnourished upon admission.
- Weight loss is common during hospitalization and persists in the post-discharge period.
- Early malnutrition detection and intervention are essential for mitigating long-term patient and healthcare consequences.
Objective:
The prevalence and follow-up of the clinical real-world data focussing on existing or risk of malnutrition in a tertiary hospital general paediatric ward including 4 months of follow-up was assessed.
Methods:
Measurements included anthropometric measurements, a nutrition interview and an extended version of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP). R Studio 3.4.2 was used for statistical analysis and diagnosing malnutrition by calculating height-for-age (HfAz)-, weight-for-age (WfAz)- weight-for-height (WfHz)-, body mass index-for-age (BMIz) and mid-upper-arm circumference (MUACz)-z-scores with the childsds package with KIGGS and WHO for reference.
Results:
The median age of the 68 participants was 8.00 (4.00-13.00) years. The main reasons for hospitalisation in the tertiary centre were gastrointestinal diseases, diabetes mellitus and rheumatic diseases. At admission 39.71%, at the second examination 36.00% and at the third examination 45.90% were malnourished. 68% of inpatients lost weight during their clinical stay, of which 35.29% lost more than 3% of their initial weight. However, changes were not significantly different.
Conclusion:
A significant share of patients was diagnosed to be malnourished at admission, the majority of patients lost weight during their hospital stay and the 4 months after admission. Due to the far reaching consequences for patients, doctors, health insurance and politics, the early diagnosis and treatment of malnutrition should take greater account in the future.
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