Epidemiological data on nutritional disorders and outcomes in hospitalized Thai children: an analysis of data from
Suchaorn Saengnipanthkul1, Jeeraparn Phosuwattanakul2, Kaewjai Thepsuthammarat3
1Division of Nutrition, Department of Pediatrics, Faculty of Medicine Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
Insights
Malnutrition affects 2.2% of hospitalized Thai children, with micronutrient deficiencies being most common. Protein-energy malnutrition (PEM) significantly increases hospital stay, costs, and mortality, highlighting the need for early detection and intervention.
Area of Science:
- Pediatric Nutrition
- Hospital Medicine
- Public Health
Background:
- Malnutrition is a common yet overlooked issue in hospitalized patients.
- Assessing nutritional disorders in pediatric populations is crucial for improving healthcare outcomes.
Purpose of the Study:
- To determine the prevalence and patterns of nutritional disorders among hospitalized children in Thailand.
- To analyze the association between protein-energy malnutrition (PEM) and clinical outcomes.
Main Methods:
- Retrospective review of hospitalized children (1 month to 18 years) diagnosed with nutritional disorders from 2015-2019.
- Data sourced from the National Health Security Office, classified using ICD-10-CM codes for undernutrition, overweight/obesity, and micronutrient deficiencies.
Main Results:
- Malnutrition was identified in 2.2% (115,254/5,188,033) of hospitalized children.
- Micronutrient deficiencies (1.81%) were most prevalent, followed by overweight/obesity (0.27%) and PEM (0.21%).
- PEM was linked to longer hospital stays, increased costs, and higher mortality rates.
Conclusions:
- Hospitalized children present with diverse nutritional disorders, notably PEM, impacting morbidity and mortality.
- Implementing nutritional screening tools and ICD codes for nutritional care is recommended.
- Reimbursement for nutritional interventions, education, and provider empowerment are vital for enhancing hospital care and patient outcomes.
Objectives:
Malnutrition in hospitalized patients is a frequently overlooked health issue. We aimed to assess the prevalence and pattern of nutritional disorders in hospitalized Thai children from the National Health Database.
Methods:
Hospitalized children aged 1 month to 18 years diagnosed with nutritional disorders between 2015 and 2019 were retrospectively reviewed using the National Health Security Office data. Based on the International Classification of Diseases, 10th revision, Clinical Modification, nutritional disorders were classified into 3 major forms of malnutrition: undernutrition (E40-E46), overweight and obesity (E66), and micronutrient deficiencies (D50-D53, E50-E56, E58, E60-E61, and E63).
Results:
Out of 5,188,033 hospitalized children, malnutrition was identified in 115,254 (2.2%). Protein-energy malnutrition (PEM), overweight and obesity, and micronutrient deficiencies were prevalent in 0.21%, 0.27%, and 1.81%, respectively. Among those with micronutrient deficiencies, 95.0% had iron deficiency anemia, 2.2% had vitamin D deficiency, and 0.7% had zinc deficiency. Children aged under 5 years mostly had PEM, followed by iron deficiency anemia. Teenagers commonly had obesity and vitamin D deficiency. Patients with PEM who were admitted with common diseases had significantly longer hospital stays and higher hospital costs and mortality rates than those without PEM.
Conclusions:
Hospitalized children had various nutritional disorders, particularly PEM, which was associated with higher morbidity and mortality. Nutritional screening tools should be utilized for the early detection and treatment of malnutrition. Specific International Classification of Diseases codes for nutritional care services and intervention should be available. Additionally, nutritional interventions should be reimbursed, along with nutritional education and empowerment of healthcare providers, to improve hospital care service and improve patient outcomes.
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