Peer-reviewed article
Assessment of nutritional status of critically Ill pediatric patients and its impact on outcome in a low-and middle-income settings
Aya Osama Mohamed, Asmaa El Sayed, Dina Mohamed Hassan, Shereen A. Mohamed ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This prospective observational study followed 250 children admitted to a paediatric intensive care unit for 28 days. It assessed their nutritional status using body measurements and two screening tools (PYMS and STRONGkids). About 59% of the children were underweight and/or stunted at admission. After adjusting for other factors, how sick a child was on admission (PRISM score) predicted death, the need for mechanical ventilation and feeding interruptions better than baseline malnutrition did. The study describes nutritional status and outcomes; it does not test an intervention.
Key points
- 59.2% of patients were underweight and/or stunted at admission, and 59% at day 28 of follow-up.
- PYMS and STRONGkids scores were significantly higher among underweight and/or stunted children on day 1 and during follow-up (p < 0.05).
- Admission PRISM score independently predicted mortality (aOR 1.50, 95% CI 1.19-1.88), mechanical ventilation (aOR 1.18, 95% CI 1.07-1.31) and feeding interruptions (aOR 1.29, 95% CI 1.16-1.45).
- Socioeconomic status was independently associated with feeding interruptions and length of stay.
- Baseline malnutrition was not independently associated with mortality, mechanical ventilation, feeding interruptions or length of PICU stay.
Limitations
The abstract does not say where the study was done beyond the Egypt hint, nor give details of the sample, the setting or the follow-up losses. As an observational study, it shows associations, not causes, and it does not test any nutrition intervention.
Abstract
Malnutrition among children is a crucial public health issue. Children in critical care units may suffer from nutritional vulnerability due to their underlying disease or barriers to nutrient delivery. Early detection and management of malnutrition may improve clinical outcomes. To evaluate the nutritional status of critically ill children admitted to the pediatric intensive care unit (PICU) and its prognostic outcome. This observational prospective cohort research entailed 250 children admitted to the PICU. All participants were assessed at admission and weekly thereafter for 28 days. Nutritional status was evaluated using anthropometric measurements and the PYMS and STRONGkids scores. The PRISM score was used to assess illness severity on the day of admission. 59.2% of patients were underweight and/or stunted at admission and 59% at day 28 of follow-up. PYMS, and STRONGkids scores were significantly higher among underweight and/or stunted on day 1 and during follow-up (p < 0.05). Multivariable regression analysis demonstrated that admission PRISM score was an independent predictor of mortality (aOR 1.50, 95% CI 1.19-1.88, p = 0.001), mechanical ventilation requirement (aOR 1.18, 95% CI 1.07-1.31, p = 0.001), and feeding interruptions (aOR 1.29, 95% CI 1.16-1.45, p < 0.001). Socioeconomic status was independently associated with feeding interruptions and length of stay. CONCLUSION: Underweight and/or stunting was common among PICU patients. PYMS and STRONGkids were effective in identifying nutritional risk. After adjustment for confounding variables, clinical severity rather than baseline malnutrition independently predicted adverse clinical outcomes. WHAT IS KNOWN: • Underweight and/or stunting were prevalent among children admitted to the PICU and this represent a crucial public health problem. • Both PYMS and STRONGkids were useful screening tools for identifying children at risk of malnutrition. WHAT IS NEW: • This study demonstrated that clinical severity and the need for inotropic support were the primary independent predictors of adverse outcomes. • The baseline malnutrition was not independently associated with mortality, mechanical ventilation, feeding interruptions, or length of PICU stay.