Elsevier

Clinical Nutrition

Volume 27, Issue 1, February 2008, Pages 72-76
Clinical Nutrition

ORIGINAL ARTICLE
Prevalence of malnutrition in paediatric hospital patients

https://doi.org/10.1016/j.clnu.2007.11.001Get rights and content

Summary

Background & aims

Childhood malnutrition has severe adverse effects on growth and development, but only limited information is available on the prevalence of malnutrition in paediatric hospital patients. We determined the prevalence of malnutrition in a series of unselected patients consecutively admitted as inpatients to a large tertiary care children's hospital in Germany.

Patients and methods

Data for weight and height upon admission were recorded in 475 unselected children aged 7.9±5 years (mean±SD). Weight for height 81–90 of median values were considered to indicate mild malnutrition, 70–80% moderate malnutrition and <70% severe malnutrition according to cut-off points defined by Waterlow.

Results

Some 24.1% of the patients were malnourished, with 17.7% of all patients who were mildly, 4.4% who were moderately and 1.7% who were severely malnourished. The largest proportion of malnourished patients was found among patients with multiple diagnoses (42.8% malnourished), mental retardation (40.0%), infectious diseases (34.5%) and cystic fibrosis (33.3%).

Conclusions

The very high prevalence of malnutrition among children admitted to a children's hospital is considered intolerable, given the adverse consequences for short- and long-term health and well-being. Strategies for systematic screening and treatment of malnutrition in paediatric patients need to be refined and implemented.

Introduction

A recent expert report of the Council of Europe highlighted major deficits in nutritional care for adult patients in European hospitals, indicating that some 20–30% of adult patients in Europe are malnourished upon hospital admission.1 However, this report devoted little attention to children. It is usually assumed that malnutrition is a severe problem particularly at old age,2, 3 but only limited data are available on the prevalence of malnutrition in paediatric hospital patients. This is rather surprising because malnutrition in children has particularly severe consequences for growth, development, health and well-being, both on a short- and long-term basis.4 In developed countries, childhood malnutrition occurs mostly secondary to chronic diseases, and it may be aggravated by frequent hospital stays and diagnostic examinations.5 We aimed at assessing the prevalence of malnutrition in a series of unselected patients admitted to a large tertiary care paediatric hospital.

Section snippets

Patients and methods

All patients consecutively admitted to one of two general paediatric wards or one paediatric surgery ward between October 1st and December 31st 2003 as well as between February 17th and April 1st 2004 were eligible for inclusion into the study if weight as well as length or height had been measured and documented. Upon admission, per standard of care, the nursing staff is supposed to record weight, and in infants supine length, or in children and adolescents standing height, with calibrated

Results

During the study period, 623 patients with available records were admitted to one of the three wards in the study. Documented measurements were available for weight in 594 patients (95.3%), height or length in 476 patients (76.4%), and both weight and height/length measurements in 475 cases (76.2%) aged 7.9±5 years (mean±SD). 281 (59.2%) were male and 194 (40.8%) female.

During the six weeks when additional measurements were performed, TSFT was measured in 134 of the 233 patients admitted during

Discussion

This study shows malnutrition to be present in 24.1% of children admitted to a tertiary care centre in Germany, an unacceptably high prevalence rate. This high rate may be due to a relatively large proportion of hospitalised children with chronic and severe disorders, whereas children with mild and acute disease are often cared for on an outpatient basis. A similar prevalence rate of 24.5% was reported in 1992 by Hendricks et al. in 268 children admitted to a tertiary care centre in Boston,

Acknowledgements

The authors thank the participating children and their parents as well as the nursing and medical staff of the assessed care units. B.K. is the recipient of an unrestricted Freedom to Discover Award of the Bristol-Myers-Squibb Foundation, New York. BK conceived and designed the study, and acts as guarantor. IP collected and calculated the data and wrote the first manuscript draft. KD advised and trained IP in measurement techniques and helped in patient recruitment and study execution. All

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