J Pichler1, S M Hill2, V Shaw3, A Lucas4. 1. 1] Department of Paediatric Gastroenterology, Great Ormond Street Hospital NHS Foundation Trust, London, UK [2] Department of Paediatric and Adolescent Medicine, University Clinic of Vienna, Vienna, Austria. 2. Department of Paediatric Gastroenterology, Great Ormond Street Hospital NHS Foundation Trust, London, UK. 3. Dietetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK. 4. MRC Childhood Nutrition Research Centre, Institute of Child Health, London, UK.
Abstract
BACKGROUND/ OBJECTIVE: The aim of the study was to compare the prevalence of undernutrition in children on presentation to hospital and on discharge. METHODS: On a screening week, 141 children aged from birth to 17 years who were hospitalised for ⩾72 h were reviewed on presentation and discharge or after 3 months (if still in hospital) by auditing hospital records. Weight for age standard deviation (s.d.<-2) was used to define undernutrition on admission and discharge. The number of children referred for dietetic advice was recorded. RESULTS: The prevalence of undernutrition on admission was 27% (14% moderate (s.d.: -2 to -3) and 13% severe (s.d.: ⩾-3)) according to weight s.d. and increased to 32% by discharge (11% moderate; 21% severe). The most nutritionally vulnerable children, with a prevalence of undernutrition from 33 to 53% on admission, were aged less than 2 years, inpatients for >1 month and those with multiple medical problems. In all, 74% (n=104) of cases were referred to Dietetics, including 73% (n=79) of those without evidence of undernutrition. CONCLUSIONS: Undernutrition is a major problem in children during hospitalisation. The risk of nutritional depletion needs to be identified at the time of admission, especially for children under 2 years and those with multiple medical problems, in order to initiate appropriate nutritional intervention.
BACKGROUND/ OBJECTIVE: The aim of the study was to compare the prevalence of undernutrition in children on presentation to hospital and on discharge. METHODS: On a screening week, 141 children aged from birth to 17 years who were hospitalised for ⩾72 h were reviewed on presentation and discharge or after 3 months (if still in hospital) by auditing hospital records. Weight for age standard deviation (s.d.<-2) was used to define undernutrition on admission and discharge. The number of children referred for dietetic advice was recorded. RESULTS: The prevalence of undernutrition on admission was 27% (14% moderate (s.d.: -2 to -3) and 13% severe (s.d.: ⩾-3)) according to weight s.d. and increased to 32% by discharge (11% moderate; 21% severe). The most nutritionally vulnerable children, with a prevalence of undernutrition from 33 to 53% on admission, were aged less than 2 years, inpatients for >1 month and those with multiple medical problems. In all, 74% (n=104) of cases were referred to Dietetics, including 73% (n=79) of those without evidence of undernutrition. CONCLUSIONS: Undernutrition is a major problem in children during hospitalisation. The risk of nutritional depletion needs to be identified at the time of admission, especially for children under 2 years and those with multiple medical problems, in order to initiate appropriate nutritional intervention.