Evaluación del estado nutricional de niños ingresados en el hospital en España; estudio DHOSPE (Desnutrición Hospitalaria en el Paciente Pediátrico en España)

Abstract

Malnutrition among hospitalized patients has clinical implications and is associated with adverse outcomes: depression of the immune system, impaired wound healing, muscle wasting, longer length of stay, higher costs and increased mortality. Although the rate of malnutrition in hospitalized children varies in different studies, it seems to be lower than in adult population. Nevertheless, this is a population that has a higher risk of developing malnutrition during hospital stay. There is a need to find the most suitable nutrition screening tool for pediatric patients. Aim: As a first step, we have performed a nationwide study on the prevalence of malnutrition on admission, in order to further evaluate the results of employing a screening tool (STAMP). Material & methods: The study is a multicenter, transversal study performed in 32 Spanish hospital between June and September 2011 in patients under 17 admitted to a the hospital longer than 48 hours. Weight, height and STAMP questionnaire were done on admission and repeated at day 7, 14 or at discharge. Nutritional status was classified according to Waterlow index for height and for weight. The study was approved by the Ethics Research Committee in each hospital and informed consent obtained prior to be included in the study. Results: 991 patients were finally included. Mean age was 5.0 years (SD: 4.6), distributed uniformly among ages. Moderate to severe malnutrition was present in 7.8%, and overweight-obesity in 37.9%. We found a significant correlation between nutritional status and type of disease. There were no correlationship with age, or with plasmatic albumin levels. Comments: This is the first nationwide study on the prevalence of malnutrition on admission in pediatric patients. Malnutrition in pediatric patients was present in around 8% of admissions, slightly inferior to other series. The most likely explanation is that the study included patients from different types of hospitals, mimicking real life conditions.