Investigation On Nutritional Status Of Hospitalized Children At Admission

Objective: This study aimed to investigate the nutritional status of pediatric inpatients and its clinical outcomes in a three level hospital in Fuzhou,so as to increase the importance we attach to the nutritional status of hospitalized children and provide a theoretical basis for clinical prevention and treatment.Method: The hospitalized children in the pediatric ward of the first Attiliated Hospital of Fujian Medical University were included from December 1st 2013 to March31 th 2016.The nutritional status were evaluated by percentages of the median values.All data were analyzed using the SPSS statistical software package program.For statistical significance one-way ANOVA and Chi-square test were used.Kaplane-Meier analysis was conducted to compare the clinical outcomes of different nutritional status.Result: Of 3525 children investigated,2196(62.3%)were boys,the median age was 2.25 years(IQR: 0.67~5.5 years old)and the median duration of hospital stay was8 days(IQR: 6 ~ 13 days).The total undernutrition rate was 36.28%.Underweight(%WFA<90%)was determined in 22.7%,with mild in 18.16%,moderate in 3.4%,and severe in 0.51%.The prevalence of stunting(%HFA<95%)was 14.07%,with mild in10.64%,moderate in 1.99%,and severe in 1.44%.Some 19.69% of the patients were wasting(%WFH < 90%),with 14.39% of all patients who were mildly,4.31% who were moderately and 0.99% who were severely wasting.Overweight(%WFH<110%)and obese(%WFH<120%)were determined in 14.07% and 11.97%,with mild obese in 6.73%,moderate in 3.92%,and severe in 1.32%.There were no significant statistical differences between boys and girls in underweight and stunting.The boys had significantly high prevalence of wasting and total undernutrition than girls.Infants and adolescent children were more likely to have poor nutrition.Comparing diagnostic groups showed the higher prevalence for overall undernutrition for inherited metabolicdisease(75.86%)and gastrointestinal disorders(47.69%).For obesity,the higher prevalence was found in children with infectious diseases(17.02%)and urinary system diseases(15.79%).We used time-effect analysis to evaluate the length of stay and hospital cost by Kaplan-Meier assay.Compare with normal nutrition,undernourishment was associated with longer LOS [mean(standard error),x(Sx)] [26.93(0.50)days vs15.61(0.57)days;c 2=28.924,P < 0.001] and higher the average hospital cost[￥17438(1623)vs ￥10560(714);χ~2=41.459,P<0.001].Conclusion: The high of the prevalences of undernutrition and obesity in hospitalized children is considered intolerable.Given the adverse consequences for short-and long-term health and well-being,the nutritional evaluation of all patients is necessary.Compared with those without undernutrition,children with undernutrition had significantly longer length of stay and higher hospitalized cost.Nutrition intervention should be carried out as early as possible.