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Pediatría (Asunción)

versão On-line ISSN 1683-9803


ACEVEDO, Esther et al. Clinical course of nutritional status in hospitalized pediatrics patients. Pediatr. (Asunción) [online]. 2005, vol.32, n.2, pp.12-18. ISSN 1683-9803.

Introduction: There is evidence to support the importance of nutritional status (NS) in predicting response to treatment in hospitalized children. Objective: To determine the in-hospital evolution of NS in pediatric patients hospitalized in the Centro Materno Infantil of the Hospital de Clínicas. Materials and Methods: Longitudinal retrospective and prospective study, with an analytical component. Sampling was random, probabilistic. Subjects included were patients <16 years, hospitalized in the pediatric service of the Centro Materno Infantil in June and July 2004. A total of 170 randomly selected patients were included. These were divided into 2 groups: a) malnourished (N=75) y b) not malnourished (N=95). Variables studied: weight, height, age, edema, breast feeding (BF), exclusive breast feeding (EBF), beginning of supplementary feeding, number of diseases, type of diet, in-hospital clinical course. The DNT classification was used, following WHO criteria (growth curves of the NCHS). Statistical analysis: central tendencies, dispersion, chi square (x2), Fisher's test, and Odds Ratio (OR). An alpha error of 5% (p<0,05) was considered significant. EPINUT, Epi Info 6.04 and Excel 5.0 were used. Results: nursing children were hospitalized more frequently than other age groups (74%). There were no differences by sex. A greater risk of malnutrition was found in mothers with <9 years of schooling (OR 3.55 CI 1.47-8.77). Most, 92%, had received BF, but 46.5% of the malnourished had not received EBF (p<0.001). The prevalence of lower respiratory tract and gastrointestinal illnesses was greater in the malnourished group (68,4%vs31,6%; p<0.004). Nutritional status on admission: eutrophic 88/170(52%), obese 1/ 170(0.5%), overweight 6/170(3.5%), malnourished 75/170 (44%); low height in 38/170 (22%). Of all complications seen, 72% were in malnourished patients (p=0.0039). Malnourished patients had longer hospital stays than non-malnourished patients (12.4 vs 6.4 days; p= 0.00001). Mortality was 5%. Nutritional status on hospital discharge: 67% no change, 21% improved and 12% worsened. The prevalence of in-hospital malnutrition was 12%, with nursing children atgreatest risk (Fisher's test p=0.05). Conclusions: Malnourished children when hospitalized have a history of shorter breast feeding and mothers with little school education, as well as a high risk of prolonged hospital stay and greater complications than non-malnourished children.

Palavras-chave : Hospital malnutrition; Malnutrition; Nutritional status.

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