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Micronutrient Deficiencies and Their Impact on Hospitalization Duration in Pediatric Palliative Care: A Retrospective
Doğukan Mustafa Keskin1, Ayhan Çeri1
1Department of Pediatrics, Dr. Ali Kemal Belviranlı Obstetrics and Gynecology Hospital, Konya, Türkiye.
Insights
Micronutrient deficiencies, particularly low vitamin D, are common in pediatric palliative care patients and linked to longer hospital stays. Enteral nutrition support also predicts prolonged hospitalization.
Area of Science:
- Pediatric Palliative Care
- Clinical Nutrition
- Micronutrient Metabolism
Background:
- Pediatric palliative care (PPC) patients often face complex health challenges.
- Micronutrient deficiencies can impact patient outcomes and hospital stay duration.
- Understanding these deficiencies is crucial for optimizing care in PPC.
Purpose of the Study:
- To determine the prevalence of micronutrient deficiencies in hospitalized PPC patients.
- To investigate the association between these deficiencies and the length of hospital stay.
Main Methods:
- Retrospective analysis of 81 children in a PPC unit.
- Assessed serum levels of ferritin, vitamin D, vitamin B12, and folate.
- Compared clinical and laboratory data based on short (≤5 days) vs. long (>5 days) hospital stays using logistic regression.
Main Results:
- 45.68% of patients had at least one micronutrient deficiency.
- Prolonged hospital stays correlated with higher ferritin and lower vitamin D levels.
- Enteral nutrition support (OR: 4.931) and lower vitamin D levels (OR: 0.937) predicted longer hospitalizations.
Conclusions:
- Lower vitamin D levels and the need for enteral nutrition support are significant predictors of prolonged hospitalization in PPC.
- Routine micronutrient screening and targeted interventions may improve patient outcomes.
Objective:
To evaluate the frequency of micronutrient deficiencies and assess their association with the duration of hospital stay in pediatric palliative care (PPC) patients.
Materials And Methods:
This retrospective study analyzed 81 children hospitalized in the PPC unit of Dr. Ali Kemal Belviranlı Obstetrics and Gynecology Hospital. Data included demographics, clinical characteristics, nutritional status, and serum levels of ferritin, vitamin D, vitamin B12, and folate. Hospital stay was categorized as short (≤5 days) or long (>5 days) based on median duration. Clinical and laboratory parameters were compared between groups, and multivariate logistic regression was used to identify independent predictors of prolonged hospitalization.
Results:
The median age was 51 months, and 58.02% of the patients were male. Neurological or neuromuscular conditions were the most common underlying diagnoses (66.67%). At least 1 micronutrient deficiency was observed in 45.68% of patients. The frequency of folate, ferritin, vitamin D, and vitamin B12 deficiencies was 9.88%, 12.35%, 7.41%, and 1.23%, respectively. Patients with prolonged hospital stays had significantly higher ferritin levels (127.5 vs. 43.8 ng/ mL; P = .001) and lower vitamin D levels (26.68 ± 9.70 vs. 31.77 ± 11.36 ng/mL; P = .033). In multivariate analysis, nutritional support via nasogastric or gastrostomy tube (odds ratio [OR]: 4.931; 95% confidence interval [CI]: 1.310-17.385; P = .018) and lower vitamin D levels (OR: 0.937; 95% CI: 0.896-0.991; P = .020) were independently associated with prolonged hospitalization.
Conclusion:
Lower vitamin D levels and enteral nutrition support are linked to prolonged hospitalizations in PPC patients. Routine screening and timely interventions may help improve outcomes.
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