The Clinical Application Of The Nutritional Risk Screening And Nutritional Assessment In Children With Sepsis

Purpose:The purpose of this topic is to investigate the incidence of nutritional risk and malnutrition in children with sepsis,to analyze the relationship between the incidence of nutritional risk and malnutrition and gender, age and degree, and to investigate the relationship between nutritional risk, malnutrition and clinical outcome in children with sepsis?Methods:This survey included 201 patients with sepsis. We used the nutrition risk screening tool(STRONGkids) and the physical development indexes to investigate the incidence of nutritional risk and malnutrition in children with sepsis. We compared and analyzed the relationship between nutritional risk, malnutrition and clinical outcome according to the course of illness, the length of stay, the total cost of hospitalization, the complications, the prognosis of the patients and so on.Result: Of the 201 children with sepsis,91% of the children with nutritional risk, 54.7% of the children with malnutrition.Among all the children with sepsis, the incidence of nutritional risk and malnutrition of the male were 91.6% and 53.8%, the incidence of nutritional risk of the female were 90.2% and 56.1%. The incidence of nutritional risk and malnutrition was not related to sex.The children with sepsis were divided into 4 groups according to their age, which were the infant group, the infant group, the preschool group and the school age group. The incidence of nutritional risk in each group was 98.2%,92.2%,83.3%,59.1%,there was significant difference. The incidence of malnutrition in each group was 55.5%,58.8%,55.6%,40.9%,there was no significant difference. Children with high nutritional risk were mainly concentrated in infants less than 1 years old, and the children with moderate nutritional risk were mainly concentrated in 1-3 years old.There was a significant difference in the incidence of high, medium and low nutritional risk among all age groups.The patients with sepsis were divided into sepsis group and severe sepsis group according to the severity of the disease.The incidence of nutritional risk and malnutrition in the patients with sepsis were 83% and 45.5%. the incidence of nutritional risk and malnutrition were 91% and 54.7% in the patients with severe sepsis, there was significant difference. The patients with sepsis were divided into 3 groups according to the pediatric critical illness score(PCIS), which were the non hazardous recombination,the dangerous recombination and the extremely dangerous recombination.The incidence of nutritional risk in each group was 50%, 92.6%, 97.3%, The incidence of malnutrition in each group was 25%, 51.5%, 63.6%, there was significant difference.The patients with sepsis were divided into 3 groups according to STRONGkids nutritional risk screening tool Rating Scale score standard, which were the low, medium and high nutritional risk group. The incidence of malnutrition in each group was 0%, 49.3%, 89.2%,there was significant difference.The incidence of malnutrition in children with high nutritional risk group was higher than that in low and medium risk group.The time of onset of disease, length of stay, total cost of hospitalization, number of organ damage and prognosis were compared between the nutritional risk group and the non nutritional risk group, the malnutrition group and the non malnutrition group,the time of onset of disease and the total length of stay of the risk group and the malnutrition group were longer, the total hospitalization cost of the risk group and the malnutrition group were higher, the number of organ function injury of the risk group and the malnutrition group were more, the risk group and the malnutrition group had worse prognosis,there was significant difference. It was found that there was a positive correlation between nutritional risk and disease severity, organ dysfunction, time of onset,hospitalization time, total hospitalization expenses, and was negatively correlated with disease outcome, there was significant difference.It was found that there was a positive correlation between malnutrition and disease severity, organ function injury, time of onset,hospitalization time, total hospitalization expenses, and was negatively correlated with disease outcome, there was significant difference.Conclusion:The incidence of nutritional risk and malnutrition in children with sepsis was higher. In clinical work, we should pay more attention to the nutrition assessment and monitoring in children with sepsis,especially for infants younger than 1 years of age and the PCIS score less than 70 points in critically ill children. In children with sepsis, the higher the nutritional risk, the higher the risk of malnutrition. The clinical outcome of patients with sepsis with a nutritional risk(or malnutrition) is even worse.