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Clinical Outcomes in Critically Ill Children With Excess Weight: A Retrospective Cohort Study

Caroline Abud Drumond Costa1, Rita Mattiello2, Gabriele Carra Forte3

  • 1Post-graduate Program in Pediatrics and Child Health, School of Medicine, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|July 4, 2020
PubMed

Insights

Overweight children and adolescents admitted to the pediatric intensive care unit (PICU) did not show an independent association with poor outcomes. However, excess weight may still pose a risk for adverse clinical events in critically ill pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Public health
  • Nutritional science

Background:

  • Childhood and adolescent overweight is a significant public health issue due to its high prevalence and detrimental effects on quality of life and longevity.
  • Critically ill children and adolescents in the pediatric intensive care unit (PICU) represent a vulnerable population where nutritional status may influence clinical outcomes.

Purpose of the Study:

  • To investigate the association between nutritional status, specifically overweight, and clinical outcomes in critically ill children and adolescents.
  • To determine if excess weight is a risk factor for adverse events in the PICU.

Main Methods:

  • Retrospective cohort study including children and adolescents admitted to a PICU over a three-year period.
  • Nutritional status categorized using body mass index z-scores according to World Health Organization (WHO) criteria (underweight, adequate weight, overweight).
  • Assessment of clinical outcomes including mortality, mechanical ventilation requirement, length of hospital stay, and multiple organ dysfunction syndrome.

Main Results:

  • Out of 1407 included patients, 16.2% were classified as overweight and 15.8% as underweight.
  • Descriptive analysis indicated higher mortality rates at the extremes of nutritional status (underweight and overweight).
  • No independent association was found between nutritional status categories and mortality in the overall analysis.

Conclusions:

  • Nutritional status, including overweight, was not independently linked to adverse clinical outcomes in critically ill children and adolescents.
  • Overweight should be recognized as a potential risk factor that warrants consideration for adverse clinical outcomes in pediatric intensive care unit admissions.
Abstract

Keywords:
body mass indexcritical illnessmortalityoverweightpediatric intensive care unitspediatrics

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